$/rvu?

[AKMD_1984]

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Hey guys

I’m 10 years out of training and negotiating with a hospital system for rvu based pay arrangement.

It’s major metro area.

I gave them a day rate and they said it needs to be an rvu based arrangement.

I do bread and butter interventions plus scs trials. I don’t do implants (will refer to surgeon). Comprehensive multidisciplinary pain mgt practice.

I haven’t been keeping up with comp models, but can you tell me what’s reasonable rvu dollar amount?

Mix of consults plus procedures.

 

[DOctorJay]

anywhere from $60-70/wRVU (at 10,000 wRVUs that's a swing of $100,000).

I'd recommend reaching out to similar employed docs and ask them this question in the local market to get a sense of what you can expect. read the fine print and make sure the conversion doesn't decrease the more you produce (i.e. run the numbers at 8,000, 9,000, 10,000 wRVUs).

 

[Ducttape]

you can check MGMA for average $/wRVU or check on old posts on this forum.

you could use the data posted here, but it is not region specific:

https://forums.studentdoctor.net/threads/latest-mgma-wrvu.1495063/#post-24337678

 

[drusso]

Hey guys

I’m 10 years out of training and negotiating with a hospital system for rvu based pay arrangement.

It’s major metro area.

I gave them a day rate and they said it needs to be an rvu based arrangement.

I do bread and butter interventions plus scs trials. I don’t do implants (will refer to surgeon). Comprehensive multidisciplinary pain mgt practice.

I haven’t been keeping up with comp models, but can you tell me what’s reasonable rvu dollar amount?

Mix of consults plus procedures.

They can pay you a daily rate, and you can be a 1099 contractor. I'd stand your ground. Just because they don't WANT to pay you how you want to be paid doesn't mean they shouldn't.

 

[SSdoc33]

They can pay you a daily rate, and you can be a 1099 contractor. I'd stand your ground. Just because they don't WANT to pay you how you want to be paid doesn't mean they shouldn't.

high likelihood hospital will tell you to go pound sand if you demand to be a 1099

funny how drusso is the king of hospital negotiations when he is PP guy. not sure how that works

 

[drusso]

high likelihood hospital will tell you to go pound sand if you demand to be a 1099

funny how drusso is the king of hospital negotiations when he is PP guy. not sure how that works

They can pay you whatever they want. Don't forget that.

 

[gdub25]

high likelihood hospital will tell you to go pound sand if you demand to be a 1099

funny how drusso is the king of hospital negotiations when he is PP guy. not sure how that works

I'd say you're both right. They CAN pay a 1099 but likely won't. Every hosptial wants to stay in line with all the others. Everyone pays on RVU so none will want to step out from that.

 

[SC Tian]

They can pay you a daily rate, and you can be a 1099 contractor. I'd stand your ground. Just because they don't WANT to pay you how you want to be paid doesn't mean they shouldn't.

interesting statement, if you are a single pain provider with a unique skill set, able to show them the potential revenue you can bring in, and they urgently need you, it is possible, I doubt in a large metro area you can negotiate above 70 per wRVU.

 

[Dr. Ice]

interesting statement, if you are a single pain provider with a unique skill set, able to show them the potential revenue you can bring in, and they urgently need you, it is possible, I doubt in a large metro area you can negotiate above 70 per wRVU.

What exactly comprises a unique skill set of reimbursable procedures that can generate volume based on current insurance reimbursement?

 

[SC Tian]

What exactly comprises a unique skill set of reimbursable procedures that can generate volume based on current insurance reimbursement?

The administers in the hospital or large non-profit groups are good at looking at numbers and clinical vision and urgent needs, for example, the revenue for SCS implants is comparable to or better than ACDF, and one level lumbar spinal fusion, if you can show them how many stims you can do in one year, how good you are at this is very good bargaining power.
Some hospital system has difficulty with patients from previous providers, I recall one provider negotiated a 600k base 5 years ago because he said he was competent in managing the residual pump patients in the hospital they were desperate.

 

[drusso]

The administers in the hospital or large non-profit groups are good at looking at numbers and clinical vision and urgent needs, for example, the revenue for SCS implants is comparable to or better than ACDF, and one level lumbar spinal fusion, if you can show them how many stims you can do in one year, how good you are at this is very good bargaining power.
Some hospital system has difficulty with patients from previous providers, I recall one provider negotiated a 600k base 5 years ago because he said he was competent in managing the residual pump patients in the hospital they were desperate.

No one believes it, but they really can pay you anything they want to...just not based on volume nor a percent of revenue.

 

[SC Tian]

No one believes it, but they really can pay you anything they want to...just not based on volume nor a percent of revenue.

Thanks for expressing your opinion 😉 what they want depends on many factors, some of which I mentioned above, I can name a few hospitals they did as well.

 

[AKMD_1984]

"Thank you very much for reaching out. The first step is to reach an agreement on the professional fees, and I am working on that right now. We will not be offering a daily rate but a per-click fee based on the service rendered. "

What does per-click fee based on service rendered mean?

 

[Ronin1]

The click is the wrvu pellet. It will magically be about 65/unit. They may increase it via directorship and quality bonus stuff as well. My hospital would not negotiate off the 65 number but did throw more money at the other components to make it 72/ unit all in