RVU and conversion factor fairness

[bigjim]

I am a new grad and have taken a few jobs in a very tight market. I was thankful to get a few gigs and load my plate (so to speak) but have now done a lot more research on how I actually get paid. I have a great understanding of the rvu/cpt/conversion factor setup with CMS. Unfortunately, I've found that one of my employers is using the RVU payments from the year 2000. I broke down my first paycheck to see I was only getting 3.06 RVUs for a level 5, while the updated 2010 RVU is 3.8 (these are work RVUs). They pay me per work RVU generated. There is no base pay or hourly, pure productivity. I looked back in my contract, and sure enough, buried in there is "rvus will be paid according to CMS 2000 schedules..) Damn!

Is anyone else in a similar situation? How much are people getting paid per RVU generated? I know CMS pays out around $36.50.

Please feel free to IM me if you'd like. I want to be careful not to make a big stink before I have some more information on my side.

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[southerndoc]

You'll find that disclosure of RVU compensation will likely violate non-disclosure agreements with most corporations/groups. So be careful before posting your actual RVU pay.

CMS may reimburse a certain amount, but keep in mind the cost of overhead and malpractice costs (25-35%) if your group provides malpractice. Malpractice insurance for a typical emergency physician is between $30-75,000 per year.

 

[zeitgeber]

That is really unfortunate that they buried it in the contract, and I'm not sure you have much legal recourse. However, I am amazed that you make that much money per RVU generated. Even with an incredible payor-mix, with something like 85% collections, you are getting paid handsomely, assuming there is good volume to keep you busy and productive. Not that you shouldn't feel wronged, but rest assured that if you're generating ~10-12 RVU's per hour (busy, but not unreasonable) you are making significantly more money than 99% of EP's.

 

[Arcan57]

Working full-time at that place would be generating me $578k/year at ~ my current RVUs/hr. Getting screwed out of .8 RVUs on a level five would probably drop me down to ~8 RVUs/hr. Which would only give me $463k/yr. I would definitely stop working there until they raise your compensation to a fair amount.

 

[GeneralVeers]

Working full-time at that place would be generating me $578k/year at ~ my current RVUs/hr. Getting screwed out of .8 RVUs on a level five would probably drop me down to ~8 RVUs/hr. Which would only give me $463k/yr. I would definitely stop working there until they raise your compensation to a fair amount.

My productivity last month at our main site was over 12 RVU/hour, but I made nowhere near that $$ amount you quoted. I feel ripped off! I really need that Bentley....

 

[SolidGold]

I'm reviewing a contract from a group that uses a pure RVU based compensation plan. It specifically states a dollar per RVU rate. It is about 40% less than what CMS reimburses per RVU. Malpractice and occupation specific long term disability is completely paid.

This is the first contract I've seen so I don't know how RVU based compensation plans look like for different groups. Based on the dollar per RVU rate that is written, my compensation could be on the higher end of what I've heard going around knowing what the average physician in the group generates for RVUs/hour.

So my question is, do I really get that stated dollar per RVU that is specifically there in the contract? (Maybe I'm just being paranoid )

 

[gutonc]

I'm reviewing a contract from a group that uses a pure RVU based compensation plan. It specifically states a dollar per RVU rate. It is about 40% less than what CMS reimburses per RVU. Malpractice and occupation specific long term disability is completely paid.

This is the first contract I've seen so I don't know how RVU based compensation plans look like for different groups. Based on the dollar per RVU rate that is written, my compensation could be on the higher end of what I've heard going around knowing what the average physician in the group generates for RVUs/hour.

So my question is, do I really get that stated dollar per RVU that is specifically there in the contract? (Maybe I'm just being paranoid )

Sounds like that's what you'll get, and you're definitely being (appropriately) paranoid.

This is one of those situations where you need to hold your nose, forget what you think you know about lawyers and have a contract/employment attorney review this (and any other contract you're offered) for you. The compensation is probably the least obfuscated thing in the contract.

 

[SolidGold]

Sounds like that's what you'll get, and you're definitely being (appropriately) paranoid.

This is one of those situations where you need to hold your nose, forget what you think you know about lawyers and have a contract/employment attorney review this (and any other contract you're offered) for you. The compensation is probably the least obfuscated thing in the contract.

Thanks, all great points, I do plan on getting it reviewed by a contract attorney.

 

[Mastodynia]

Are we talking rvu or wRVU? Our patients are about 2.7 wrvu each on average. I see 3.1 patients/hr for just over 8.25 wrvu/hr. That is working fast and hard as well.

What is your average patient wrvu and how many pts/hr are you seeing? What is typical e/m average?

 

[neuro kid]

In favor of non disclosure statements- I am not talking about myself, but about a physician ZZZ

I am not an ER physician, but do feel that there are a lot of hidden caveats in most practices. XYZ's contract says "current RVU dollar equivalent". What he ran into is the fact that the hospital board still consider 2009 to be "current". Dont know how to fight it- his contract lawyer says that it depends on the board to define "current".

Also, does someone have insight into the difference between Work RVU and Professional Component as far as diagnostic studies are concerned? which one should a physician get for overseeing an ultrasound for eg?