Compensating physicians for inpatient OB services can be complicated by OB global codes that are ascribed to deliveries. The complexity often increases when evaluating inpatient labor and delivery services under varying contractual relationships that exist, 通常在同一组织内(如.g., hospitalist versus non-hospitalist models; inclusion of advanced practice providers [APPs]; providers who are employed, 简约, 或者从学术医疗中心租借).
为了应对这些挑战, it is important for provider compensation administrators to understand that there are numerous ways to compensate OB/GYN physicians and choose the approach that’s best for their organization and provider group.
补偿住院病人提供云顶集团的方法
There are three primary ways that organizations typically compensate physicians for inpatient delivery services:
- 全球代码WRVU归属: WRVUs associated with a global code are split up and credited to each physician who provided a component of OB care.
- 补偿(内部或不受限制): 市场呼叫覆盖转移率是按呼叫向提供商支付的, 不管每班送多少货. Depending on how this payment is structured it may also include some consideration for WRVUs, 如果使用, 或收藏, 如果合同.
- 分娩津贴: 一次性付款支付给完成分娩的云顶集团40011官网, 所有门诊云顶集团都是单独记账的.
大多数组织选择WRVU归因方法为雇用的云顶集团40011官网, 因为在确定所提供的实际云顶集团的报酬时,这是最公平的. 在合适的薪酬模式和护理环境下, there is an opportunity to use this methodology for other OB/GYN providers as well (e.g.,注册护士及助产士). 但这也给行政管理带来了负担, and leaders need to fully consider the methodology’s benefits and challenges before adopting it.
WRVU归因策略解释
Before considering whether a WRVU attribution policy is a good fit for your organization, 重要的是要了解这样的政策是如何运作的. 最常, 与全局代码相关的wrvu分为三个部分:产前, 生产前的, 和产后. WRVUs are credited to the provider(s) who rendered each visit or procedure and then multiplied by a compensation per WRVU rate specific to the provider type (e.g., 如果认证护士助产士是护理模式的一部分, WRVUs may be respectively attributed and multiplied by a rate that is within FMV for that provider type).
在这种假设的情况下. Sample provides a vaginal delivery for a patient; 59400 is the CPT code assigned. 这是一个全局代码,属性为37.根据2024年医疗保险医师收费表(MPFS). 而不是补偿博士. 示例为整个全局代码WRVU量, WRVUs may be attributed according to a formula such that each physician who provided professional services covered by the global code may receive WRVU credit, 相应的. 表1和表2显示了wrvu如何分配给Dr. 样品和博士. Alternative和Dr. 例如,谁也提供病人护理覆盖的全球代码.
表1: 使用实例WRVU归属策略 |
![]() [1] CPT codes for single services may be used to establish WRVUs for each component of a global OB code. 另外, “proxy” WRVUs may be credited to each component of care such that the entire global code WRVU value is fully distributed. 本例演示了后一种方法. |
表2: 按医师划分的总WRVUs |
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权衡WRVU归因策略的利弊
医疗保健组织的下一步是检查自己的结构, 管理资源和流程, 以确定WRVU归因策略是否合适.
该政策确实为组织提供了各种各样的好处. Physicians and administration alike will be able to transparently understand the work each physician is doing. 这可能导致医疗保健组织遇到以下情况:
- 生产力量化补偿: 对于那些通常根据WRVUs支付云顶集团40011官网工资的组织来说, it may be important to align compensation with peers and support the culture of the physician group.
- 与公平相关的医师满意度: Physicians may feel more satisfied receiving credit for actual services rendered in lieu of credit being applied in a more vague manner (e.g., 津贴), whereas a single physician may receive all WRVU credit for an OB global code or even no WRVU credit despite providing care throughout the OB cycle of care.
- 鼓励团队合作: Physicians will be encouraged to assist with the care of patients assigned to other physicians because WRVUs will be credited for such effort. 这可能支持以团队为基础的护理,同时也可能防止云顶集团40011官网倦怠.
尽管如此,使用WRVU归因策略也带来了挑战. 并非每个医疗保健组织都具备实现这种补偿方法的能力, 领导者应该意识到几个常见的障碍:
- 行政负担高: Physician compensation departments need to have adequate physician compensation staffing and technological processes in place for the policy to be successful and accurate. 实施还需要对云顶集团40011官网进行教育, 教育计费部门, 促进所有相关利益相关者之间的合作. 这很重要, as compensation will need to be calculated regularly and the policy will need to be continually reassessed in the context of any market updates (e.g., MPFS更改为OB全局代码).
- 云顶集团40011官网报酬的财务影响的可变性: 由于OB体积和编码的可变性, healthcare organizations may find it more difficult to budget spend associated with a WRVU attribution methodology.
- 合规风险考虑因素: If WRVU attribution policies are inaccurately designed or executed, there may be compliance risks. This is especially true if the total number of WRVUs attributed to a single global OB code exceeds the value of the global code itself. 此外, the fair market value (FMV) of physician services should be assessed based on actual physician services provided. This becomes difficult for organizations and internal FMV teams that are unfamiliar with the nuanced nature of compensating physicians for OB services.
替代的方法
如果WRVU归因策略对于医疗保健组织似乎不合理, 呼叫补偿和交货津贴可作为备选办法. 两者都很容易管理. The budgetary impact of call compensation will also be easily ascertained and consistent throughout the year.
然而, 电话费率可能无法反映每个班次的负担, 如果每次轮班的负担波动,可能会降低云顶集团40011官网的满意度. 另外, delivery stipends may also result in minimal or even no compensation depending on how busy the inpatient service is and may also encourage competition or one physician staying late to deliver a baby after their shift to ensure payment. Each of these approaches require a high level of collegiately among the providers to ensure equity and satisfaction while avoiding internal competition.
选择最合适的方法
当组织考虑如何补偿住院分娩云顶集团时, a WRVU attribution policy serves as a potentially ideal methodology that can capture each component of professional physician services under a global OB delivery code, increasing transparency and providing healthcare organizations various advantages that serve to encourage physician satisfaction, 招聘, 和保留.
As healthcare organizations weigh the pros and cons of the approach and consider alternatives, guardrails should be put in place regardless of the chosen approach to ensure successful administration and compliance.
编辑:Matt Maslin
出版于2024年5月9日