Pay cuts

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Yeah I’m not sure if it’s isolated to my region or what but constant talks of financial stress and not being sustainable due to decreasing compensation and rising operating costs. The competing local healthcare system just cut compensation and everyone is saying we’re next.
 
Attending1985 said:
Yeah I’m not sure if it’s isolated to my region or what but constant talks of financial stress and not being sustainable due to decreasing compensation and rising operating costs. The competing local healthcare system just cut compensation and everyone is saying we’re next.
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Sounds like some people need to start looking at private practice. Reimbursements have been going up, not down, in my region for psychiatric services
 
Compensation is not going down and operating costs (beyond inflation) are not going up. If anything, costs go down with telehealth. I'd want to see some data from any current employer who said this kind of thing to justify a pay cut.
 
If they actually attempt to cut pay and/or come at you with a new worse contract. Walk.
And have this sound track on your mind:


This is likely the preamble move to shuffle up their work force and infuse more ARNPs. If they keep you for less it is a win. If you walk, they win, they get an ARNP from a mill in a few months. Go get your own win. Find a place that values you, they still exist, or hang that shingle.

"Attending1985, LLC now accepting new patients"
 
ARNP salaries are definitely on the rise too. There continues to be plenty of business for everyone.
 
Sushirolls said:
If they actually attempt to cut pay and/or come at you with a new worse contract. Walk.
And have this sound track on your mind:


This is likely the preamble move to shuffle up their work force and infuse more ARNPs. If they keep you for less it is a win. If you walk, they win, they get an ARNP from a mill in a few months. Go get your own win. Find a place that values you, they still exist, or hang that shingle.

"Attending1985, LLC now accepting new patients"
Click to expand...

Maybe it’s the push I need get into something more meaningful which I’ve been wanting to do for a long time
 
Attending1985 said:
Yeah I’m not sure if it’s isolated to my region or what but constant talks of financial stress and not being sustainable due to decreasing compensation and rising operating costs. The competing local healthcare system just cut compensation and everyone is saying we’re next.
Click to expand...

Lol “decreasing compensation.” Ya decreasing for the front line workers wtf
 
for me ive been lucky and it was the opposite, i got a 10% raise in october. But so far I really like the system I work for. If theres talk of decrease your salary I would smile and say "that sounds ok" and then immediately go look for a new job. Sometimes the grass is greener on the other side...
 
Insurance rates in PP here are increasing year of over. It's about keeping the rates up to date and budgeting your overhead wisely. Play it right and you get ongoing raises--and there's inflation. Event United gave a systemic raise to my geographic area. Sizable one.
 
We had a ~10% cut in the wrvu conversion rate but also updated wRVUs to the 2021 values (they previously were frozen to 2020 values). Not sure what to make of that.
 
We did not get a raise or cut, but after first year salary is based on production for previous 12 months for me anyway. In Feb or March our academic center updated wRVU reimbursement to 2023 levels retroactively, so got a decent little bump to my production for the work I've done in 2023.
 
There was a 10% pay cut at a big child psychiatry group in my state after private equity money came in, which was supposed to increase the pay for psychiatrists but did the opposite. Many if not most of the child psychiatrists left.
 
Heist said:
I think insurance will not be paying as much for online appts anymore so they may be bracing for that.
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Most states now have telemedicine parity so they are required to pay the same for telehealth appointments. In addition, big hospital systems most always get the same if not more for telehealth since they have massive leverage in negotiations. In my old job, the hospital billed a telemedicine fee and some insurers actually paid it meaning they made more on telehealth than in person visits!
 
splik said:
Most states now have telemedicine parity so they are required to pay the same for telehealth appointments. In addition, big hospital systems most always get the same if not more for telehealth since they have massive leverage in negotiations. In my old job, the hospital billed a telemedicine fee and some insurers actually paid it meaning they made more on telehealth than in person visits!
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So the insurance companies have to pay those rates? Even if the company is located in another state?
Also looks like there will be overall Medicare cuts that will probably cause private insurance to drop rates too. CMS physician fee schedule rule cuts payments, expands telehealth reimbursement past 2023
 
Employed here, about a year ago everyone got a tiny increase. They have told us if by next year we don't reach 50th percentile for RVU, we will receive a cut commensurate with our productivity.
 
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comp1 said:
Compensation is not going down and operating costs (beyond inflation) are not going up. If anything, costs go down with telehealth. I'd want to see some data from any current employer who said this kind of thing to justify a pay cut.
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Even if they "justified" it with numbers it would only prove to me that they are bad at business and I shouldn't work for them.
 
clozareal said:
There was a 10% pay cut at a big child psychiatry group in my state after private equity money came in, which was supposed to increase the pay for psychiatrists but did the opposite. Many if not most of the child psychiatrists left.
Click to expand...
I think there will be a lot of this happening over the next few years, as PE thinks they can milk psychiatry in the same way they have done anesthesia and EM. The thing they don't realize is we can just walk away since we can work out of literally a walk-in closet if we wanted
 
claypigeon said:
We had a ~10% cut in the wrvu conversion rate but also updated wRVUs to the 2021 values (they previously were frozen to 2020 values). Not sure what to make of that.
Click to expand...
Same here. Ended up making more total than the previous year with about the same amount of work (since for E&M codes the RVU value increased 20-30%).
 
splik said:
Most states now have telemedicine parity so they are required to pay the same for telehealth appointments. In addition, big hospital systems most always get the same if not more for telehealth since they have massive leverage in negotiations. In my old job, the hospital billed a telemedicine fee and some insurers actually paid it meaning they made more on telehealth than in person visits!
Click to expand...
Was the parity only during COVID emergency?
 
Mad Jack said:
I think there will be a lot of this happening over the next few years, as PE thinks they can milk psychiatry in the same way they have done anesthesia and EM. The thing they don't realize is we can just walk away since we can work out of literally a walk-in closet if we wanted
Click to expand...

jbomba said:
California enacted this in 2019
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Any other states?
 
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