WRVUs and guaranteed salary in offer

[Igor4sugry]

Anyone receive contracts for a job that has guaranteed base pay but does not include actual WRVU #s for when guaranteed pay ends?
I got such a contract (outpatient only), that is for 36months, first 24months have a guaranteed salary. But after this there is a Base Compensation (Production model) and Value Compensation (based on quality/satisfaction etc). The issue is that the contract doesn't actually list # of WRVUs they expect or the median rate.

Base Compensation is based on WRVUs up to median threshold x70% median rate. (doesn't specify # for median threshold). Value compensation is WRVUs up to Median threshold x20% median rate.

Is this how private hospital systems generally setup their RVU payment structures?

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[nexus73]

Sounds like you need more details. It all sound pretty confusing. I would hope the medical director or HR could explain it in simpler terms. One issue is the value per rvu changes some every year. My job sets the rvu value at 70%, based on the MGMA salary survey. They should be able to tell you what that value is currently, but the value can change every year so they can't promise what it will be in 24 months. Hopefully higher than the current value.

 

[SeniorWrangler]

If they don't give you the numbers, then the numbers are going to be higher than you will ever achieve working outpatient, and you should assume you're going to be working for the base compensation forever.

 

[Shikima]

Sounds like you need more details. It all sound pretty confusing. I would hope the medical director or HR could explain it in simpler terms. One issue is the value per rvu changes some every year. My job sets the rvu value at 70%, based on the MGMA salary survey. They should be able to tell you what that value is currently, but the value can change every year so they can't promise what it will be in 24 months. Hopefully higher than the current value.

MGMA is out the door because the demand is higher than "statistics" can provide in an annual report. If you look at the current offers, most are circulating around 300k with some healthy sign-on for typically inpt work, or a combo of out/inpt.

 

[nexus73]

MGMA is out the door because the demand is higher than "statistics" can provide in an annual report. If you look at the current offers, most are circulating around 300k with some healthy sign-on for typically inpt work, or a combo of out/inpt.

Interesting, have people been seeing inpatient offers this high with 40 hour weeks and no call?

 

[Shikima]

Interesting, have people been seeing inpatient offers this high with 40 hour weeks and no call?

Everything is negotiable.

 

[Information Underload]

You want this stated verbatim in your contract. Don't take them at their word on this. You probably want to know what the heck "Value Compensation" means, as well.

 

[SeniorWrangler]

MGMA is out the door because the demand is higher than "statistics" can provide in an annual report. If you look at the current offers, most are circulating around 300k with some healthy sign-on for typically inpt work, or a combo of out/inpt.

WHere are you? This is way higher than what I see on the West Coast.

Edit: psych demand is always higher than supply, but psych loses money compared to Ortho, oncology, or almost anything, so the demand goes unmet. My state has had a psych bed shortage since the 60's and it's getting worse, not better.

 

[Shikima]

WHere are you? This is way higher than what I see on the West Coast.

Edit: psych demand is always higher than supply, but psych loses money compared to Ortho, oncology, or almost anything, so the demand goes unmet. My state has had a psych bed shortage since the 60's and it's getting worse, not better.

Midwest. CA has lower because the shortage isn't as much, plus the cost of living (housing, goods, taxes) isn't a good place to be.

I also disagree that psych loses money. We don't get paid equitably (and then add MOC as an added incentive to give up more money). I work far less than my surgery and medicine counterparts and earns as much equally.

 

[Igor4sugry]

Right, many things are not clear. They are not willing to provide any RVU #s given 2 year of guaranteed salary.
A concern is that once guaranteed salary period ends I go to Production only, I get paid 80% of my salary on bi-weekly basis and the other 20% gets paid out semi-annually (along with these "value compensation"). I thought this was quite strange. Why would a hospital pay its physicians 80% and the other 20% twice per year?

 

[Shikima]

Right, many things are not clear. They are not willing to provide any RVU #s given 2 year of guaranteed salary.
A concern is that once guaranteed salary period ends I go to Production only, I get paid 80% of my salary on bi-weekly basis and the other 20% gets paid out semi-annually (along with these "value compensation"). I thought this was quite strange. Why would a hospital pay its physicians 80% and the other 20% twice per year?

Keep more money in the profit margin for which they can generate more revenue with. Remember, it takes money to make money.

 

[nexus73]

It's probably confusing on purpose. My productivity pay is crystal clear. No questions how I'm paid.

 

[SeniorWrangler]

It's probably confusing on purpose. My productivity pay is crystal clear. No questions how I'm paid.

Exactly! It's confusing to you, but not the suits writing the contract. That should tell you something.

 

[Information Underload]

Why would a hospital pay its physicians 80% and the other 20% twice per year?

I am guessing this is value pay based on patient satisfaction or some metric they measure twice per year.

 

[OldPsychDoc]

Right, many things are not clear. They are not willing to provide any RVU #s given 2 year of guaranteed salary.
A concern is that once guaranteed salary period ends I go to Production only, I get paid 80% of my salary on bi-weekly basis and the other 20% gets paid out semi-annually (along with these "value compensation"). I thought this was quite strange. Why would a hospital pay its physicians 80% and the other 20% twice per year?

We're based on production as well, and they pay us a regular biweekly amount and a twice yearly "reconciliation" which reimburses the production in excess of that. Some years this is pretty close to 20%.