RV What?

[napoleondynamite]

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Being in academics there is not a lot of discussion about RVU's. However, just as an FYI, for the first time since taking my job a year ago one of our finance people circulated a chart that shows how much revenue each of the docs has brought in this year as well as how many RVU's.

Turns out I've brought it more cash than most, but I am the lowest RVU producer in my department. Not that I care, but I would like to understand how that is possible?

Can anyone help me out with a good resource or explanation for RVU's? I tried Youtube and got some sucktard recruiter who wasn't helpful, and Wikipedia's version didn't really answer my particular question. I can't wrap my mind around how your gross revenue can be really high, but your RVU's low..am I just a slacker or what? lol

 

[deleted4401]

Very strange!
Each RVU has a specific dollar value, about 35 bucks. So, more RVUs are more money. But, if you have less Medicare and Medicaid patients, then you may make more.

 

[Gfunk6]

To give you a rough ball park, the "average" Radiation Oncologist sees 250-300 new patient consults per year. If you assume an average mix of IMRT/3D/electrons then generation of 15,000 RVU per year would be the 50th percentile.

If you multiply 15,000 RVUs x $35 avg = $525k revenue generation per year for the "average" Rad Onc

In your situation, you should identify if they mean gross or net revenue. If your gross revenue is higher, then that is a bit strange. If your net revenue is higher, it could be because you are being paid less for doing equal (or more!) work. Such is the pain of starting out as an attending . . .

BTW, here is an online PDF from Merritt Hawkins that explains the principles behind RVUs.

 

[Tanner]

Being in academics there is not a lot of discussion about RVU's. However, just as an FYI, for the first time since taking my job a year ago one of our finance people circulated a chart that shows how much revenue each of the docs has brought in this year as well as how many RVU's.

Turns out I've brought it more cash than most, but I am the lowest RVU producer in my department. Not that I care, but I would like to understand how that is possible?

Can anyone help me out with a good resource or explanation for RVU's? I tried Youtube and got some sucktard recruiter who wasn't helpful, and Wikipedia's version didn't really answer my particular question. I can't wrap my mind around how your gross revenue can be really high, but your RVU's low..am I just a slacker or what? lol

These are the likely scenarios:

1) You bring in nonclinical revenue- research (RO1 grant), honorariums, directorships, supplemental salary.
2). This is a net revenue and your total practice cost was lower than your colleagues
3) You are not a partner yet, so you do not have other financial burdens
4) They screwed up the accounting.
5) You are a magician and this is beyond my scope of understanding basic practice finances.

 

[MOHS_01]

More favorable payer mix or more favorable CPT mix (you're doing more expensive treatments than your peer group) -- those are the only two possibilities if all monies were generated clinically.

 

[OTN]

Seems very likely to be due to a favorable payer mix issue. For example, if you specialize in cervical cancer your $$ intake is going to be lower than someone who specializes in prostate cancer for the same RVU amount.

 

[napoleondynamite]

More favorable payer mix or more favorable CPT mix (you're doing more expensive treatments than your peer group) -- those are the only two possibilities if all monies were generated clinically.

You guys are right on the payer mix thing. I tend to get more international (cash) patients than my colleagues. But I guess I'm still a little confused as to how that makes my RVU's lower. Are RVU's more a function of how much work you are doing (how many consults, sims, etc) than how much money you bring into a practice?

 

[deleted4401]

Yeah - it quanitifies everything you do and gives it a dollar value. But, if you're seeing cash patients and better insured patients, your dollar value of each RVU is higher than your colleagues. Makes sense. You're the RAINMAKER!

S

 

[Gfunk6]

You guys are right on the payer mix thing. I tend to get more international (cash) patients than my colleagues. But I guess I'm still a little confused as to how that makes my RVU's lower. Are RVU's more a function of how much work you are doing (how many consults, sims, etc) than how much money you bring into a practice?

RVUs can be used as a proxy for the amount of work that you do. The revenue that you generate is directly related to RVUs but it is not a 1:1 correlation. For example, let's say three MDs generate 15k RVU per year in the following scenarios:

#1 sees all Medicare patients - generates 1x revenue
#2 sees 50% Medicare, 40% Medicaid, 10% no insurance - generates 0.7x revenue
#3 sees 20 % Medicare, 80% private insurance - generates 1.3x revenue

What we're saying is that you may be in the latter category. Therefore, even if your RVUs are technically lower, your reimbursement rate may be (more than) enough to make up for it because of the payor class of your treated patients.