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Overcoming Physician
Contracting Challenges with
MD Ranger
Today’s goals
• Physician contracting trends and challenges• Discuss how healthcare organizations use MD
Ranger• Demo online platform
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WHY PHYSICIAN CONTRACTING MATTERS
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Costs soaring, performance falling• 4-6% total operating
expenses• Expense that has been
largely ignored• Huge impacts on
financial performance, organizational performance, physician relationships
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Physician costs per ADC as a percent of total hospital expense (OSHPD*)
*Office of Statewide Health and Planning Department (California)
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Administrative payments increasing
Direction and admin total
hospital payments now $1.8M, up 25% from 2014
Leadership position payments
at the 75th percentile grew from $52,630 in 2015 to $60,000
in 2016
Chief of Staff median payments
increased from $36,000 in 2015
to $48,500 in 2016
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Factors driving increased payments
Increased time demands of physicians such as• JAHCO requirements• Technology and quality initiatives• Peer review• Committee and meeting attendance• Board responsibilities
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Factors driving increased payments• Trend of increased hospital-based medicine
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Factors driving increased payments• Economic and market forces, such as:
• lower reimbursements, • larger group practices with productivity incentives, • more part-time and employed physicians, and • competing internal governance demands of a practice are
These factors likely reduce the pool of physicians interested in committing time without reasonable payment, thus increasing the amount of financial arrangements with physicians for coverage, leadership, and administrative roles.
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Competing priorities for doctors
More physicians are reluctant to take call, serve as medical directors, or run for medical staff office if it results in lower revenue and fewer patients, or if duties impinge on either clinical or after-hours activities.
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OIG keeps warning us….
• Fraud alerts• More and more Stark, AKS settlements• Yates memo=personal accountability
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Specific (and common) challenges• Current system isn’t working• Physician costs are spiraling• Unsure all your contracts are FMV compliant• No standardization across facilities• Concerned about government audits,
whistleblowers• Don’t know what you don’t know
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What do you do?
• Set up systems and processes• Determine if your current spend is
appropriate• Valuing physician arrangements• Think strategically about the future,
especially regarding:• Changing reimbursement• Evolving physician compensation structures• Unpredictable, dynamic industry
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What stands in your way?
Lack of resources
Poor sources of data from bad market surveys
Expensive solutions
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About Us
ABOUT US
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250+ Physician Benchmarks• Call coverage rates• Medical direction payments• Administrative and leadership
services rates• Hospital-based service stipends• Diagnostic testing, etc.• Clinic & hourly rates
Online Platform• Benchmark lookups• Contract proposal tools• Contract reports by facility and
service• Total facility costs +
benchmarks
Compliance Documentation• Contract-specific FMV
documentation reports• Reports to assist with real-time
monitoring and annual reviews
Research and Support• Resources for education and
training• On-call experts to help
subscribers use benchmarks and tools
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The foundation of your compliance process
Standardize processes and rates across the
organization
Look up and document physician rates for
FMV
Access 250+
payment benchmarks
Review contracts annually
and monitor with ease Have
smarter, data-driven physician
negotiationsMitigate
compliance risks with
comprehensive source of benchmark
data
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Our subscribers
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Our benchmarks• Call Coverage• Medical direction• Administrative• Medical Staff Leadership• Hospital-based services• Diagnostic/other services
e.g. ROP, autopsy, dialysis• Hospital-based stipends• Clinics, professional services• Telemedicine• Residency/teaching/GME
• Uncompensated care• Meeting attendance, peer
review, IT/EHR and quality initiatives
Hospital-characteristics drill down for ADC, bed size, trauma status, urban/rural, stroke centers, and more
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New services for 2016
Antibiotic Stewardship Medical Direction
Bioethics Medical Direction Chief of Staff Elect Neuro Interventional Call Coverage Pediatric Ophthalmology Call
Coverage Perioperative/Recovery Medical
Direction Robotic Surgery Medical Direction Stroke telemedicine…And 25+ more
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Our methodology: key differences
• Providers vs. facilities• Verified data• Thorough data audits• Physician contract experts
on-call to review/advise on challenging contracts
• Comprehensive scope of benchmarks based on full hospital contracting practices
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Contract review and monitoring support
MD Ranger’s online platform includes:• Executive Report
• Spending by contract type• Spending by facility• Spending by service/service line
• Total Benchmarking Report• Facility Comparison Tool
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Extensive education and analysis for subscribersContracting• What You MUST Know About Compensating Call
Coverage (video)• Benchmarking Total Physician Costs (video)• Making Physician Contracting More Efficient (white
paper)
Compliance:• Defining, Determining, and Documenting FMV (video)• Stark Law and Physician Contracting (video)• Audit Smart (video)• Four Signs Your Organization Could Have Risky
Contracts (checklist)
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Meeting the unique challenges of healthcare organizations
Make data-driven decisions for your organization, each and every time
Stop relying on poor data sources
Streamline documentation and ensure you are protected against costly settlements
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A breakthrough resource for health systems
Allows implementation of system-wide policies that lead to reduced corporate support and reliance on valuations
Includes comparisons of facilities across the system and benchmarks
Identifies opportunities for cost reduction, with reports designed especially for health systems
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Meeting the unique challenges of small hospitals
Though physician contract values are lower, the amount spent is proportionately higher at small hospitals
MD Ranger serves as both a contract management system and a source of benchmarks
Straightforward compliance reports help streamline documentation, cut out unnecessary steps as well as FMV opinions
Manage physician contract compensation and document FMV—without overextending your
staff or resources
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Value for consulting firms
Benchmarks for 250 physician services, most of which can be found no where else, at your fingertips.
Benchmarks for making strategic financial and operational choices, like total call coverage costs and benchmarks on number of positions
Online platform for organizing and tracking your clients' performance, as well as easy, on the go lookup tools for MD Ranger physician comp benchmarks
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MD RANGER DEMOUsing lookup toolsProposing rates and documenting negotiated ratesAnalytics and Reports for smarter strategies
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Don’t just sit on less than ideal agreements: do something.
Do you feel confident in your organization’s physician contracting and FMV documentation process?
Are you confused how much to pay physician leaders for their time?
Do you feel like your organization has risky agreements?
We can help! Reach out: [email protected] or 650-692-8873
