Fee-for-sevice newbie

[bthings]

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I'm a CA3 and have been interviewing in the PA, DE, NJ area for over a month with a couple of decent but not great partnership offers. Recently I received an offer from a group that is entirely eat what you kill income. I'm not too familiar with the perks and pitfalls of this type of arrangement so I thought I'd let some of the pros take a look at the offer.

Here's what the group president laid out:

1. 100% fee-for-service 3yr partnership make 70% of billed units yr 1, 80% yr 2, 90% yr 3, 100% as partner. 4wks vacation, but can take as much or as little as you want.
2. Avg member billing ~11500 units/yr at 46$/unit. Any procedures I do (ie post op pain blocks) are directly reimbursed to me with no 30% cut to partners.
3. Rotation for case choices and call, so no cherry picking. Older partners are working less and taking less call so opportunity to take on more but completely voluntary.
4. I am responsible for malpractice(~14k), health(~12k), pension(~49K), FICA(~10K), group expense(15K).

Location is good for me. Met all the partners and they seemed happy. Did all the math and asked each partner individually what i could expect. After deductions avg partner making 350-500K depending on how hard they work and how much vacation. A couple of out-lier guys who do some pain work supposedly making $700-800k.

Any insight and advice from those who know would be greatly appreciated.😀

Thanks

-B

 

[sevo85288]

sounds good. just ask about the payor mix. $46/unit pooled is v. good. Group expense is not bad at 15K/yr. just ask the name of the last guy who left and give him/her a call. 11,000 units is pretty laid back. what types of case, CV, neuro etc. is there a call stipend.

 

[bthings]

Thanks for the reply Sevo,

Cases are mostly bread and butter with the occ AAA, ortho trauma, aprox. 1100 births/yr. Call is from home. Speaking with the group president he said that the current payor mix was very good something like 20-30% mcare/caid, the rest private.

Last guy left to go do surgicenter full-time and because the group did not "blend" their units. Appearantly, this guy got hosed on that. However for the last 2 yrs the group has used the blended unit for all employee reimbursment.

Good question about the call stipend I'll have to ask but, my guess is no.


Thanks again,

-B

 

[TheSandMan]

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[bthings]

The group I've signed up with has a similar payer mix, but their blended unit is much smaller, in the 30's. They quoted $50 from private payers, $10 from medicaid, and $20 from medicare. Out of this, we are still responsible for billing, which runs about 6%. Does this mean that there is room for growth in this group since they seem to getting underpaid per unit?

My understanding is that the blended unit rate in $ is calculated by the average of the private insurance payment (higher) vs govt insurance payment(lower).

By that Logic I guess the only way to increase the value of your blended unit is to have private insurance companies that pay more per unit or to have a greater proportion of private payors vs govt payors.

Anyone else have any thoughts?

-B