On-call arrangements continue to be an ongoing challenge for hospitals and healthcare systems. Ensuring continuity of coverage for not only emergency departments (ED) but for inpatient specialty practices has proven difficult for a variety of reasons. Many hospitals are required to maintain a panel of on-call physicians in order to preserve their trauma status and for regulatory compliance requirements.

However, the volume and acuity of ED coverage has increased across the country. 这些变化, coupled with the lowering supply of physicians and advanced care practitioners and providers’ increased focus on work-life balance, have resulted in overall increases in on-call pay in order to ensure proper coverage.

在制定随叫随到的安排时，你应该考虑什么?

结构及保障安排

There are a number of ways to structure compensation within an on-call arrangement; as you can see in the chart below, 每天的津贴是, 毫无疑问, 最常见的支付结构. 无论补偿方式如何, hospitals are finding more and more ways to compensate physicians for the burden of being on-call. We continue to see the percentage of physicians that receive payment for on-call services increase. 根据 沙利文销 供应商随叫随到补偿调查和 MGMA 随叫随到薪酬调查, an average of 50% to 70% of hospitals are now paying their physicians for on-call services.

电话收费结构图

并发的报道

并发覆盖有多种形式和大小. The important thing to note when considering the utilization of a concurrent coverage model is that this coverage is provided by a single physician. This means a single physician is available to multiple facilities or multiple service lines. As summarized in the chart below, there are many pros and cons to concurrent call coverage. One pro is the ability to cover multiple facilities or multiple specialties with a single call panel. 这使医院能够维持所需的覆盖范围, even with limited physician supply and makes for easier tracking of the on-call panel. However, 这也可以被认为是提供并发覆盖的一种手段, because it requires a physician to be available to more than one facility or more than one specialty at any given time potentially increasing the burden and rate of pay for that coverage.

同时覆盖的利弊

公平市价(FMV)

One compliance best practice is the evaluation of terms and compensation within a proposed arrangement in two ways. 首先，确认安排符合a Stark 异常和/或 Anti-Kickback雕像 安全港(如适用)和第二, 确认赔偿是FMV, 商业上合理的, 并且不考虑推荐的数量或价值. In determining FMV for on-call arrangements, there are number of important components to consider:

  • 医生可用性;
  • 保险负担;
  • 病例敏锐度;
  • Facility Designations; and
  • Payor Mix

Considering the burden of an on-call panel can take a few different forms, it’s important to include both the number of times the physician takes a phone call during an on-call shift and the number of times a physician is required to present on-site during an on-call shift. While a phone call doesn’t necessarily result in any type of face-to-face consultation or patient procedure, it does indicate how often the physician is interrupted during a call shift. 另一方面, the number of times that a physician presents on-site is a major indicator of the value of a call coverage panel. 这些因素, 随着案件的尖锐, 是否有指标显示提供者在随叫随到时处理了什么.

Another important indicator of FMV is potential reimbursement for services provided when on-call. This has more of an impact for independent contractors than employed physicians due to billing and collection responsibilities. 在考虑报销时, it’s important to also consider the acuity of the cases as well as a facility’s payor mix. Reimbursement and the potential uncompensated care for self-pay patients or under-compensated care can have a potentially large impact on FMV and should be considered carefully.

LBMC帮助您保持公平市场价值的脉动

Keeping a PULSE on FMV compensation can be complicated and time-consuming. 医疗保健组织正面临着越来越多的挑战. As a national leader in healthcare advisory services for over 30 years, our FMV calculators provide solutions for a variety of simple to complex provider compensation arrangements including: employment, 呼叫覆盖和管理服务. And best of all, they’re fast and can be completed in less than a minute. 如果您的医疗保健组织正在寻找自动化的, 评估薪酬条款的基于web的解决方案, the PulseFMV计算器 你对FMV支持辩护的回答是什么.

Content provided by LBMC Healthcare Compensation Valuation professional Jessica Webster.