Latest MGMA

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
N

Nodolor

Full Member
Joined
Dec 14, 2020
Messages
599
Reaction score
336
Points
2,046
  1. Attending Physician
Advertisement - Members don't see this ad
I believe MGMA just came out with most recent numbers if I am not mistaken for reimbursement.

Anyone have access to those and mind sharing?

I am in current contract negotiations

Thanks
 
If anyone even has it 😂, doesn't it cost like 600 bucks.
 
Advertisement - Members don't see this ad
So median for anesth. Went down about 9k I will tell you that. I don’t have the full report. Median rvu down about 50.
 
Recent numbers were probably impacted by COVID. For the purpose of contract negotiation you might be better off using the 2019 data.
 
Agast said:
Recent numbers were probably impacted by COVID. For the purpose of contract negotiation you might be better off using the 2019 data.
Click to expand...
Just found out that is what they are using secondary to unknown variables and implications of Covid
 
YearPM&R MGMA MedianPM&R MGMA 75AMGA PM&R MedianAMGA 80AMGA non-anes pain 50AMGA pain 80
2016​
$ 61.62$ 72.41$ 60.40$ 79.50
2017​
$ 61.30$ 72.13$ 62.63$ 79.24$ 69.40$ 86.70
2019​
$ 64.27$ 75.94$ 84.84$ 70.89$ 97.92
2020​
$ 65.09$ 79.89
$63.19​
$ 80.62$ 70.45$ 96.00
 
cowboydoc said:
YearPM&R MGMA MedianPM&R MGMA 75AMGA PM&R MedianAMGA 80AMGA non-anes pain 50AMGA pain 80
2016​
$ 61.62$ 72.41$ 60.40$ 79.50
2017​
$ 61.30$ 72.13$ 62.63$ 79.24$ 69.40$ 86.70
2019​
$ 64.27$ 75.94$ 84.84$ 70.89$ 97.92
2020​
$ 65.09$ 79.89
$63.19​
$ 80.62$ 70.45$ 96.00
Click to expand...
MGMA data doesn't calculate average RVU for Anesthesia pain, but they have ASA units, income data. I can share what I have. Apparently, my org doesn't have the new data yet, as I just received the 2020 report from 2019 data. I'm happy to share, just not sure it's kosher to post?
 
any hard numbers besides mgma? #methree
 
Advertisement - Members don't see this ad
If you guys are medical students. try your medical library. They should have a copy. If not, request that they purchase one.
 
thecentral09 said:
I’m very interested if anyone can post as well. I have older info if that helps
Click to expand...
Couple places I talked to , said they are still using 2019 numbers because they felt 2020 Covid numbers where not as accurate
 
Advertisement - Members don't see this ad
Hey guys regarding the MGMA data, is it different for hospital based practices? I am 2 years into a hospital based practice and currently undergoing contract extension negotiations with my employer. I brought up the point that since I am doing procedures in a hospital setting (higher facility fees for them) that my base should be higher as my bonus is wRVU based and not collections based (which I realize is appropriate for most hospital based practices). Their response was they can't consider my work/collections in the hospital as this violates Stark laws. They also said giving me a higher base and compensating me "higher than fair market value" is also potentially problematic for them if they are audited. I am not sure if they are trying to get out of paying me or if what they are saying has merit to it. I do not have much experience with contract negotiations but if anyone has any input it's much appreciated!
 
FentanylFairy said:
Hey guys regarding the MGMA data, is it different for hospital based practices? I am 2 years into a hospital based practice and currently undergoing contract extension negotiations with my employer. I brought up the point that since I am doing procedures in a hospital setting (higher facility fees for them) that my base should be higher as my bonus is wRVU based and not collections based (which I realize is appropriate for most hospital based practices). Their response was they can't consider my work/collections in the hospital as this violates Stark laws. They also said giving me a higher base and compensating me "higher than fair market value" is also potentially problematic for them if they are audited. I am not sure if they are trying to get out of paying me or if what they are saying has merit to it. I do not have much experience with contract negotiations but if anyone has any input it's much appreciated!
Click to expand...
Depends on what your base is now.
 
FentanylFairy said:
Hey guys regarding the MGMA data, is it different for hospital based practices? I am 2 years into a hospital based practice and currently undergoing contract extension negotiations with my employer. I brought up the point that since I am doing procedures in a hospital setting (higher facility fees for them) that my base should be higher as my bonus is wRVU based and not collections based (which I realize is appropriate for most hospital based practices). Their response was they can't consider my work/collections in the hospital as this violates Stark laws. They also said giving me a higher base and compensating me "higher than fair market value" is also potentially problematic for them if they are audited. I am not sure if they are trying to get out of paying me or if what they are saying has merit to it. I do not have much experience with contract negotiations but if anyone has any input it's much appreciated!
Click to expand...

The hospital is absolutely trying to get out of paying you. Typically they want 75th percentile work for 25th percentile pay.

Generally, hospital administration has a poor understanding of how the Stark Law applies to employed physicians.

In general, they cannot pay you more than your collections, from what I understand.

The term fair market value will get thrown around a lot as well also. This phrase is poorly defined in my experience as it is not as simple as stating it is 50th percentile on one of the numerous salary surveys.

What can happen is administration hires am outside consultant to determine a compensation range. Administration will use this information and make you an offer, usually based on the lower end (you will never know what the range is since they will never divulge this).

There are a couple of ways to approach this (not exhaustive list)
1. Straight productivity model
WRVU x conversion factor = compensation
This is simple. Someone posted some mgma data which lists the median $/rvu

You should have detailed knowledge of your rvus for your 2 years.

2. Base + Productivity
Usually you will have to meet some rvu threshold in order for Productivity to kick in.

3. Only base with no productivity
I don't see this too often because administration is typically afraid one will have no incentive to work etc.

Then there can be various stipends (clinical site director, other made up title) they can use to pump up your cash compensation.

Regarding your negotiation, what final cash compensation will make you satisfied? That is the number you need to think about in order to negotiate with an end goal in sight.
 
FentanylFairy said:
Hey guys regarding the MGMA data, is it different for hospital based practices? I am 2 years into a hospital based practice and currently undergoing contract extension negotiations with my employer. I brought up the point that since I am doing procedures in a hospital setting (higher facility fees for them) that my base should be higher as my bonus is wRVU based and not collections based (which I realize is appropriate for most hospital based practices). Their response was they can't consider my work/collections in the hospital as this violates Stark laws. They also said giving me a higher base and compensating me "higher than fair market value" is also potentially problematic for them if they are audited. I am not sure if they are trying to get out of paying me or if what they are saying has merit to it. I do not have much experience with contract negotiations but if anyone has any input it's much appreciated!
Click to expand...
MGMA is what most hospitals will use for “benchmarking.” “Not considering collections because of Stark” is laughable. You need to peruse these threads more, as there are invaluable tips on negotiating contracts.
 
anonperson said:
The hospital is absolutely trying to get out of paying you. Typically they want 75th percentile work for 25th percentile pay.

Generally, hospital administration has a poor understanding of how the Stark Law applies to employed physicians.

In general, they cannot pay you more than your collections, from what I understand.

The term fair market value will get thrown around a lot as well also. This phrase is poorly defined in my experience as it is not as simple as stating it is 50th percentile on one of the numerous salary surveys.

What can happen is administration hires am outside consultant to determine a compensation range. Administration will use this information and make you an offer, usually based on the lower end (you will never know what the range is since they will never divulge this).

There are a couple of ways to approach this (not exhaustive list)
1. Straight productivity model
WRVU x conversion factor = compensation
This is simple. Someone posted some mgma data which lists the median $/rvu

You should have detailed knowledge of your rvus for your 2 years.

2. Base + Productivity
Usually you will have to meet some rvu threshold in order for Productivity to kick in.

3. Only base with no productivity
I don't see this too often because administration is typically afraid one will have no incentive to work etc.

Then there can be various stipends (clinical site director, other made up title) they can use to pump up your cash compensation.

Regarding your negotiation, what final cash compensation will make you satisfied? That is the number you need to think about in order to negotiate with an end goal in sight.
Click to expand...
Thank you everyone for your input. I guess my point was they are using the MGMA data but I think it is for clinic based practices (the majority) vs hospital based. One of my main points was that every time I do an LESI in the hospital in an OR they are billing close to 3-4k and all I see is the 1.8 wRVU. They just kept saying they can't use the collections I've made in the hospital to negotiate because "it violates Stark law" to which I didn't know what to respond. I thought it would be fair to ask for a higher base given they are making good money off my procedural volume but they basically said they wouldn't do that unless my RVU threshold goes up (which makes me make less). I guess I should just keep my current model and ask for more compensation per wRVU?
 
I could be wrong here, but I believe they CAN consider collections that you've made the hospital, as long as there is no quid-pro-quo. Your compensation cannot be directly be tied to your collections for the hospital and they cannot give you any type of kickback or stipend because of your collections. They CAN use the money you've made the hospital as one of the factors when considering your total worth to the hospital (along with teaching responsibilities, administrative work, marketing work, etc) and thus allow you to negotiate your $/RVU. They can also give you a stipend for stupid barely-there administrator stuff as mentioned above. (i.e. We'll pay you $20K to be the "Pain Director" and $20K for being the medical director for PT, etc etc.)
 
When I signed on at my job we were told we made 75% of net patient revenue. Being a stupid young doc I thought this sounded great.

Turns out it was actually 75% of our collected physician fees. We do all our procedures in HOPD settings so it’s not great. Most hospitals probably give you 100% of your physician fees in this model.

Our model switched a few years later, my base is now much higher, but there’s essentially no incentive to produce.

So I’d say in your current situation your best bet is to push for a higher $/wRVU valuation after you surpass your base because it doesn’t sound like they’re willing to work with you in other ways.

I PM’d you some more info as well.
 
FentanylFairy said:
Thank you everyone for your input. I guess my point was they are using the MGMA data but I think it is for clinic based practices (the majority) vs hospital based. One of my main points was that every time I do an LESI in the hospital in an OR they are billing close to 3-4k and all I see is the 1.8 wRVU. They just kept saying they can't use the collections I've made in the hospital to negotiate because "it violates Stark law" to which I didn't know what to respond. I thought it would be fair to ask for a higher base given they are making good money off my procedural volume but they basically said they wouldn't do that unless my RVU threshold goes up (which makes me make less). I guess I should just keep my current model and ask for more compensation per wRVU?
Click to expand...
"They" is admin? Can you talk to your hospital's legal department? They should have a better understanding of how not to mis-apply Stark's Law.
 
Advertisement - Members don't see this ad
DOctorJay said:
When I signed on at my job we were told we made 75% of net patient revenue. Being a stupid young doc I thought this sounded great.

Turns out it was actually 75% of our collected physician fees. We do all our procedures in HOPD settings so it’s not great. Most hospitals probably give you 100% of your physician fees in this model.

Our model switched a few years later, my base is now much higher, but there’s essentially no incentive to produce.

So I’d say in your current situation your best bet is to push for a higher $/wRVU valuation after you surpass your base because it doesn’t sound like they’re willing to work with you in other ways.

I PM’d you some more info as well.
Click to expand...
My first job, in private practice, I had a salary guarantee first year then received 45% of my total collections plus benefits. I though this was pretty fair, but after the ink was dry I discovered they meant 45% of my professional collections only. I received 0% from the facility fee, in-house UDS collections, DME sales, etc. First lesson.
 
Major Payne said:
Hey guys regarding the MGMA data, is it different for hospital based practices? I am 2 years into a hospital based practice and currently undergoing contract extension negotiations with my employer. I brought up the point that since I am doing procedures in a hospital setting (higher facility fees for them) that my base should be higher as my bonus is wRVU based and not collections based (which I realize is appropriate for most hospital based practices). Their response was they can't consider my work/collections in the hospital as this violates Stark laws. They also said giving me a higher base and compensating me "higher than fair market value" is also potentially problematic for them if they are audited. I am not sure if they are trying to get out of paying me or if what they are saying has merit to it. I do not have much experience with contract negotiations but if anyone has any input it's much appreciated!
Click to expand...

Major Payne said:
Thank you everyone for your input. I guess my point was they are using the MGMA data but I think it is for clinic based practices (the majority) vs hospital based. One of my main points was that every time I do an LESI in the hospital in an OR they are billing close to 3-4k and all I see is the 1.8 wRVU. They just kept saying they can't use the collections I've made in the hospital to negotiate because "it violates Stark law" to which I didn't know what to respond. I thought it would be fair to ask for a higher base given they are making good money off my procedural volume but they basically said they wouldn't do that unless my RVU threshold goes up (which makes me make less). I guess I should just keep my current model and ask for more compensation per wRVU?
Click to expand...
Cant you just under-produce until they play ball? Limit the number of patients you see per day? Or just take your procedures to an ASC or office setting ?
 
GandalfTheWhite said:
Cant you just under-produce until they play ball? Limit the number of patients you see per day? Or just take your procedures to an ASC or office setting ?
Click to expand...
I’m not really sure how I could limit my patient load as it is mostly controlled by them and my clinic coordinator throws people on the schedule. I’m currently scheduling 32 on my 2 full days of clinic and 16-18 on my 2 half days. The rest is procedure time. The problem is my patients are canceling procedures as soon as they see the anticipated cost. I’ve been asking them to get me a different procedure area that is more affordable for patients because I have a lot of private insurance patients (who haven’t met their out of pocket or deductibles) who are getting charged way too much out of pocket so they keep calling to cancel their procedures. $1500 out of pocket for a 5 min injection is ridiculous. But of course the hospital is dragging in finding an alternative but they did say they are gonna work on opening an ASC.

The way they are playing it makes me want to just see patients in clinic and not do any procedures at all since they “can’t take my hospital collections into account.” But that’s not the type of pain practice I want to run.
 
GandalfTheWhite said:
Cant you just under-produce until they play ball? Limit the number of patients you see per day? Or just take your procedures to an ASC or office setting ?
Click to expand...
“He’s going to be a crappy employee until they pay him more”

“It’s a bold move Cotton, let’s see if it pays off”
 
Agast said:
“He’s going to be a crappy employee until they pay him more”

“It’s a bold move Cotton, let’s see if it pays off”
Click to expand...
I see you prefer a "the beatings will continue until morale improves" approach.
If they want to pay him 25% MGMA, then they should be okay with 25% MGMA production.
Sorry bruh.

Major Payne said:
I’m not really sure how I could limit my patient load as it is mostly controlled by them and my clinic coordinator throws people on the schedule. I’m currently scheduling 32 on my 2 full days of clinic and 16-18 on my 2 half days. The rest is procedure time. The problem is my patients are canceling procedures as soon as they see the anticipated cost. I’ve been asking them to get me a different procedure area that is more affordable for patients because I have a lot of private insurance patients (who haven’t met their out of pocket or deductibles) who are getting charged way too much out of pocket so they keep calling to cancel their procedures. $1500 out of pocket for a 5 min injection is ridiculous. But of course the hospital is dragging in finding an alternative but they did say they are gonna work on opening an ASC.

The way they are playing it makes me want to just see patients in clinic and not do any procedures at all since they “can’t take my hospital collections into account.” But that’s not the type of pain practice I want to run.
Click to expand...
Can you not tell your clinic coordinator to schedule less patients? Take 30 min for followups and 60 min for new patients? If youre salaried, you should take that approach. Manage them medically, and refer them out to your colleagues for procedures in the office or ASC (that is not affiliated with your hospital). That way, you see your patients, they get their procedures without paying ridiculous amounts, and you give the admins a big fat ffcuk you
 
Major Payne said:
I’m not really sure how I could limit my patient load as it is mostly controlled by them and my clinic coordinator throws people on the schedule. I’m currently scheduling 32 on my 2 full days of clinic and 16-18 on my 2 half days. The rest is procedure time. The problem is my patients are canceling procedures as soon as they see the anticipated cost. I’ve been asking them to get me a different procedure area that is more affordable for patients because I have a lot of private insurance patients (who haven’t met their out of pocket or deductibles) who are getting charged way too much out of pocket so they keep calling to cancel their procedures. $1500 out of pocket for a 5 min injection is ridiculous. But of course the hospital is dragging in finding an alternative but they did say they are gonna work on opening an ASC.

The way they are playing it makes me want to just see patients in clinic and not do any procedures at all since they “can’t take my hospital collections into account.” But that’s not the type of pain practice I want to run.
Click to expand...
Sounds eerily familiar. They “gave” me an office with a fluoro suite and subsequently quashed the plan right before the move, because someone ran the numbers on what they would lose at the HOPD ASC.
 
GandalfTheWhite said:
I see you prefer a "the beatings will continue until morale improves" approach.
If they want to pay him 25% MGMA, then they should be okay with 25% MGMA production.
Sorry bruh.


Can you not tell your clinic coordinator to schedule less patients? Take 30 min for followups and 60 min for new patients? If youre salaried, you should take that approach. Manage them medically, and refer them out to your colleagues for procedures in the office or ASC (that is not affiliated with your hospital). That way, you see your patients, they get their procedures without paying ridiculous amounts, and you give the admins a big fat ffcuk you
Click to expand...
Hahahaha
 
Ferrismonk said:
My first job, in private practice, I had a salary guarantee first year then received 45% of my total collections plus benefits. I though this was pretty fair, but after the ink was dry I discovered they meant 45% of my professional collections only. I received 0% from the facility fee, in-house UDS collections, DME sales, etc. First lesson.
Click to expand...

Could they legally give you 45% of EVERYTHING (facility fees, DME, UDS, etc)?
 
NJPAIN said:
Could they legally give you 45% of EVERYTHING (facility fees, DME, UDS, etc)?
Click to expand...

They can do whatever they want. The whole point of being an HOPD-MD is to juice the vig on the SOS. Otherwise, why bother?

@Major Payne This is what you do: Get an EOB from one of your patients. Bring it to Admin and say, "Look here MF's, look at this $h*T. This is what I'm talking about. My physician enterprise value is contained in this bloated facility. Share the pie."

Do Most Hospitals Benefit from Directly Employing Physicians?

Physicians are expensive. What can hospitals do to make sure they’re getting a return on their investments? In this piece, the authors suggest five ways that hospital leaders should rethink their strategy for their physician enterprises: First, they should establish a clear strategic goal and a...
hbr.org hbr.org
 
Advertisement - Members don't see this ad
You must log in or register to reply here.

Similar threads

P
MGMA?
2 3 4
Replies
187
Views
16K
nvrsumr
N
M
2024 IPM MGMA
Replies
4
Views
2K
Laryngospasm
Laryngospasm
G
2022 MGMA
Replies
3
Views
2K
DOctorJay
DOctorJay
LineEmTubeEm
Northeast specific MGMA data
Replies
1
Views
2K
Dr. Ice
D
P
2023 MGMA, AGMA or SullivanCotter data?
Replies
3
Views
3K
PainApp2021
PainApp2021
Top Bottom