Using ASA units for compensation determination?

[neutro]

Greetings.

Quick question:

I am looking at MGMA data for compensation adjustment, as our group felt that we are underpaid after the practice basically increased the MDs workload and responsibilities and volume. We are transitioning into more MD staffing from CRNAs.

My question is regarding units and how they're calculated in a medical direction practice? I am looking at median units for MGMA etc but are these for personally performed cases?

So if the attending anesthesiologist is seeing the patients in pre-op, and managing workflow and seeing PACU patients, but not actually doing the anesthetic, does that count towards his units?

If that is the case, then how does one determine compensation?

As you can attest, medical direction can be busy in certain situations (like ASC with 4 rooms and single physician etc). Some days I wish I did my own cases. That requires a lot of labor, but it doesn't count towards actual work units?

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[GassYous]

Reimbursement divided by number of units equals unit value. Accounts receivable minus crna salary plus benefits minus overhead (billing, taxes, medical insurance, etc) equals md salary.

 

[IMGASMD]

The number that has been thrown around is 12000 units per year.

MGMA unit value, I always assumed it’s a blended value.

The crna part, like what @GassYous said.
Busy GI center, 60 patients 4 CRNAs and you.

240 units * blended value - crna salary - overhead. Can be substantial, but you’re also signing 60 charts that day.

For eat what you kill practice, you shouldn’t have any problem to get people to do that kind of work.

 

[Cookie]

On average how many RVUs an average Anesthesiologist generate per years staffing 3-4 rooms ?

 

[GassYous]

The number that has been thrown around is 12000 units per year.

MGMA unit value, I always assumed it’s a blended value.

The crna part, like what @GassYous said.
Busy GI center, 60 patients 4 CRNAs and you.

240 units * blended value - crna salary - overhead. Can be substantial, but you’re also signing 60 charts that day.

For eat what you kill practice, you shouldn’t have any problem to get people to do that kind of work.

60 patients is like 400 units conservatively

 

[IMGASMD]

60 patients is like 400 units conservatively

I was thinking 3 based units and 15min time unit. So 4 per patient.

I think 400 is a bit high. I’ll meet you in the middle then. 320?

 

[GassYous]

I was thinking 3 based units and 15min time unit. So 4 per patient.

I think 400 is a bit high. I’ll meet you in the middle then. 320?

egds are 5, colonoscopies are 4 unless screening only. 16 minutes is 2 units.

 

[IMGASMD]

egds are 5, colonoscopies are 4 unless screening only. 16 minutes is 2 units.

I was using 3 for colon. I think that’s for CMS.

 

[Mman]

On average how many RVUs an average Anesthesiologist generate per years staffing 3-4 rooms ?

RVU is a term academic centers use to try to equate work amongst different specialties. It is not related to anesthesia billing units.

 

[Cookie]

Thank you. I think I meant to say average ASA units/year!

 

[narcotics999]

egds are 5, colonoscopies are 4 unless screening only. 16 minutes is 2 units.

I don't think you get 2 units from 16 minutes.

 

[neutro]

Reimbursement divided by number of units equals unit value. Accounts receivable minus crna salary plus benefits minus overhead (billing, taxes, medical insurance, etc) equals md salary.

Interesting, thank you.

In your experience, is this information made readily available in its entirety in an accurate and non-fudged manner when there is AMC involved?

Typically, how much % would AMC take as profit?

 

[GassYous]

Never worked for an amc but they wouldn't tell you the numbers because they wouldn't want you to get upset about how much money they are taking from you. My estimate is that they are skimming around 25-50% from what you earn.

 

[IMGASMD]

Never worked for an amc but they wouldn't tell you the numbers because they wouldn't want you to get upset about how much money they are taking from you. My estimate is that they are skimming around 25-50% from what you earn.

Even if they do, it’s probably an underestimate. The one I had the pleasure of knowing, will throw a number that they calculated out…. Without letting you know the criteria nor the rate they negotiated with the insurance company.

If you’re the original owner, perhaps you will have some idea. Whatever the revenue before compare to what they ask. Doesn’t always work out, even when they say they (amc) can negotiate a better insurance rate.

Also a place that supposedly bring a few mil to the AMC, didn’t deliver AND was in the hole. Just like any business, if it is mismanaged, it will lose money.