Latest MGMA data

[drusso]

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Negotiate your pay or contracts based upon $xx per RVU. You know what Medicare is going to pay per RVU, then try to negotiate 3.0 - 3.5 x Medicare from your commercial payers.

 

[PMR 4 MSK]

I can't tell how the system is in terms of efficiency and complication as I haven't used it so far. But on face value, it is similar to RVU system and is independent of payor mix and insurance denials. You will be billing everyone as same.
In term of incentive payout, it is similar to collections. In collection based incentive you get around 40-50% payout while, in billing you are paid 25%. Both end up giving similar take home pre-tax money.

Am I missing anything in jigsaw?



Maybe me. 😕 Still debating.

In collections-based payment, the burden of collections is shifted to the doctor, who in actuality often has little-to-no control over what is collected - s/he does not set fees, does not submit the bills to the insurance or clearinghouse, does not see the individual EOBs, does not do the call backs to see whay claims were not paid and/or processed, etc. In other words, the doc gets screwed if employees don't do their job correctly.

In RVU or billings-based payment, you do the work and submit your codes, and get paid based on that. The burden is now shifted to the collector - the person paying the doctor for his/her work.

 

[ParaVert]

3 X Medicare? Did you just arrive in the time machine from 1985? I don't have a single private insurer that pays even double Medicare. BCBS is about 1.3x for me. Medicare, Tricare and BCBS make up 90% of my total business.

Any guesses why I'm negotiating an employment contract with the hospital?

 

[ultm8frisbee]

3 X Medicare? Did you just arrive in the time machine from 1985? I don't have a single private insurer that pays even double Medicare. BCBS is about 1.3x for me. Medicare, Tricare and BCBS make up 90% of my total business.

Any guesses why I'm negotiating an employment contract with the hospital?

exactly what I was thinking, from what I've seen is around 1.5 times medicare. Anyone else care to share what they're getting?

 

[facets]

I think it depends on area. In az private fees are the same as MC. I have heard that in the midwest they get 2-3 x mc.

 

[PMR 4 MSK]

It depends on the insurer and what I'm doing.

BCBS pays me 2X MC in the office, 2.5 in fluoro.

Humana pays about 1.8 in the office, yet 3.5 in fluoro.

Cigna is paying me more to see patients often than inject them.

 

[Jcm800]

It depends on the insurer and what I'm doing.

BCBS pays me 2X MC in the office, 2.5 in fluoro.

Humana pays about 1.8 in the office, yet 3.5 in fluoro.

Cigna is paying me more to see patients often than inject them.

not me, BCBS pays me 10% above medicare.

 

[bedrock]

not me, BCBS pays me 10% above medicare.

ditto

 

[drusso]

3 x medicare??

 

[daphilster78]

Holy crap. No wonder California docs are paid so little. We are actually happy when an HMO pays Medicare rate. That's 1x; 2-3x seem ridiculous. A friend across town bragged to me that he negotiated 1.3x with a hmo-ipa group. That's what's consider high out here. I'm happy even when I see medi/medi. No ridiculous authorization process with unpredictable denials.

 

[Doctodd]

We bill 2-3x Medicare so we can justify it in court if asked. The judge/attorney will ask why you charge what u charge, trying to paint you as the greedy fraudulent doctor. You will say because your abilities are superior to your peers due to multiple board certifications, etc, and that's why you deserve 90% percentile from that mysterious book that states what your peers in your zip code/county charge.

Or you can just say its standard to bill 2-3x Medicare and hope it holds up.

The reason u bill so much is because of the occasional injury attorney or foreign insurance policy who will pay you usual and customary full bill.....which just means more taxes for the govt.....part of the game.

All pretty insignificant in comparison to the 6 figure hospital bills.

 

[RickKane]

Anyone have the regional data...specifically West with the 25% 75% etc. I m negotiating a contract and could use the help. Thanks in advance.

 

[likeaboss]

I have the 2010 mgma regional data, but not 2012. Anybody have access to the 2012 regional mgma data?

 

[PMR2008]

http://www.beckersasc.com/pain-mana...hysician-compensation-13-recent-findings.html

this might be helpful

 

[Yo GabbaPentin]

Anyone have the updated MGMA info? I will be interviewing for a new job next week and they have already asked what my proposed compensation will be. I have said that I would like at least the MGMA median. In retrospect, that may have been stupid because I do not even know what that is! Thanks for the help.

 

[Ducttape]

Anyone have the updated MGMA info? I will be interviewing for a new job next week and they have already asked what my proposed compensation will be. I have said that I would like at least the MGMA median. In retrospect, that may have been stupid because I do not even know what that is! Thanks for the help.

Just use the MGMA Dashboard

Pretty nice tool. for pain management: nonanesthesia, i am almost exactly average. for anesthesia pain management, im woefully underpaid and dont work hard

 

[epidural man]

How is it that Anesthesia pain physicians make more than non anesthesia pain physicians when they do they same type of procedures? Is it just because of sheer volume or is it the type of procedures performed?

I don't think there is any difference between board certified pain specialist (that did an ACGME pain accredited fellowship) wether they be Neurology, PM&R, pyschiatry, or Anesthesia - but no one is asking that question.

The problem is ANYONE can call themselves pain physicians, and some can even pay lots of money from any number of different accrediting bodies and get some sort of certificate.

I would guess that most that do ACGME pain fellowships end up making the same amount within a standard deviation.

So that is a dumb question - or way to delineate. They should ask ACGME pain certified vs non ACGME pain physicians.

 

[Yo GabbaPentin]

Does anyone have the info broken down by region? Where I am interviewing, I have already been asked twice what I expect compensation to be. I would love to have something a little more solid other than that dashboard if possible. Again, I have told them "the MGMA ave" but if they ask me what that is, I'll look a bit foolish.

Thanks!

 

[Ducttape]

unless someone bought the last set of data...

either use the dashboard and give them the national average, or buy the data, i guess.

that way you can tell us the most up to date infomation. 😉

 

[clubdeac]

So using the dashboard, apparently 90th percentile for compensation is $700k with collections being about 970k and gross charges 3 million. How can you take home 700k if you only collect 970k? I guess that would be an overhead of about 28%. Pretty lean...

Also if you charge 3 million and collect 970k that means you collect little less than a 1/3rd. Is that normal?

 

[Ducttape]

So using the dashboard, apparently 90th percentile for compensation is $700k with collections being about 970k and gross charges 3 million. How can you take home 700k if you only collect 970k? I guess that would be an overhead of about 28%. Pretty lean...

Also if you charge 3 million and collect 970k that means you collect little less than a 1/3rd. Is that normal?

um... i think you are taking somewhat independent data and combining them...

im sure those specific offices that are billing 3 million are collecting not only 970K. each graph is probably somewhat independent of the others. that office making 3 million hopefully is getting over 2 million in collections, dont you think?

 

[SeniorWrangler]

I wonder how much of the disparity is related to surgical procedures like pumps and stims? Not too many neurologists doing those, and they seem to be well compensated. I am never sure how seriously to take that compensation data, it always seems like the numbers are much higher than what people I know are getting.

Also, if you're in academic medicine, your pay is often tied to your specialty, so the pain-anesthesia guys are getting paid based on the anesthesia pay scale, while the pain-neurologist is getting paid on the neurology scale, even if they're basically doing the same thing all day.

 

[hyperalgesia]

Also, if you're in academic medicine, your pay is often tied to your specialty, so the pain-anesthesia guys are getting paid based on the anesthesia pay scale, while the pain-neurologist is getting paid on the neurology scale, even if they're basically doing the same thing all day.

Same thing at the VA. But I've only seen it where people have to keep their primary spec current. It may exist but I haven't seen anesthesiologists getting paid at VA for "Anesthesia-Pain" without having to take some OR call.

 

[specepic]

Does anyone have the info broken down by region? Where I am interviewing, I have already been asked twice what I expect compensation to be. I would love to have something a little more solid other than that dashboard if possible. Again, I have told them "the MGMA ave" but if they ask me what that is, I'll look a bit foolish.

Thanks!

When I negotiated my last job< I had them throw out the numbers first. They are hoping you throw out a lower number than they are thinking.

They also brought the MGMA books to the table, literally, and we looked at it together

also have them set a decent bonus threshold for you

Pay attn to:
salary offer vs MGMA (have them use national or regiona, whichever is higher)
do you have any med school loans?
$/RVU
bonus threshold

Assuming you are talking about a RVU based hosp gig I would be avail to assist. PM

 

[Yo GabbaPentin]

When I negotiated my last job< I had them throw out the numbers first. They are hoping you throw out a lower number than they are thinking.

They also brought the MGMA books to the table, literally, and we looked at it together

also have them set a decent bonus threshold for you

Pay attn to:
salary offer vs MGMA (have them use national or regiona, whichever is higher)
do you have any med school loans?
$/RVU
bonus threshold

Assuming you are talking about a RVU based hosp gig I would be avail to assist. PM

Thanks for the replies. It just seems hard for me to believe that the average compensation is what the MGMA says (>$400k). Maybe I just know the wrong people!

 

[lobelsteve]

Thanks for the replies. It just seems hard for me to believe that the average compensation is what the MGMA says (>$400k). Maybe I just know the wrong people!

Average does not equal starting.

 

[Ducttape]

As noted above, there are two pain management choices. I too would like yo see the breakdown. I'm guessing that one is purely interventional only....