What do you think would be fair compensation for this job?

[jbomba]

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I would be performing initial psychiatric evaluation and follow-ups for the patients in a six-bed primary mental health residential program. I'm envisioning one follow-up per week unless more frequent is indicated. Probably something like 8-9 intakes each month.

I know the people running it, they run a quality IOP and have excellent staff and PhD therapists. The residential will be a new program for them. The psychiatrist they have managing the IOP patients is well respected in our area.

They are open to my thoughts on compensation, whether it's hourly or per evaluation. I'm leaning towards the latter. We're envisioning something like one half day a week with the occasional zoom for occasional weekend intake or urgent appt.

This will be located in a very wealthy suburb of a high cost of living City in california, for what it's worth.

Appreciate the feedback.

 

[Bartelby]

This could be an interesting opportunity. I am interested in what others think about compensation, but I would ask for more than typical outpatient compensation.

1- these are going to be higher risk patients and the standard expected for safety monitoring, while lower than inpatient, is significantly higher than outpatient. This creates some liability risk for you even if you are not the medical director.

2- I would clarify about weekend admissions. There should not be any weekend admissions unless they are being readmitted from a medical hospitalization. On weekends there is generally more of a skeleton staff and that isn't the right time to admit.

3- the quality of the team makes a tremendous difference in residential treatment. If the other clinicians there are solid and generally work very well together (and effectively manage attempts at splitting) it will make the work much easier. If you get pulled into lots of urgent situations and drama you can expect this role to eat up a lot of your time and energy.

For a high cost of living area I would think about $400 per hour billed at one full half day on site. For any additional input such as urgent evaluations, team meetings outside of the half day, etc I would consider charging $400 per hour for that as well. Honestly though I may be underestimating, in high cost of living areas it is not unusual for cash practices to go over $500 per hour for follow-ups and that might be a reasonable target.

 

[Bartelby]

Also you might need to think about how much time will be dedicated to the residential program. I assume this is a 30-day length of stay program where you anticipate some early dropout (hence 8-9 admits per month for a 6-bed program).

If you do two admissions per week can they both be done on the same morning? Each admit will probably need a nursing assessment, psychology assessment, unit orientation, and potentially other steps like pharmacy verification if applicable. If you don't have resources to do two per morning, you either have to do two admitting days or you would need to see people days after admission (which is not optimal). I am also presuming you will not offer detox services. If so, if you are the primary provider managing detox I would expect to deal with urgent issues/questions between your on site days.

Potentially each half-day you could do:
Admission 1 (90 min)
Admission 2 (90 min)
2-4 follow ups (60-120 min)

That takes 4-5 hours on its own, so if you need to do interdisciplinary team meetings you will need to plan for that. Also consider whether you will join team meetings or see unplanned discharges on off-days. All in, I suspect this could end up adding up to a 0.2 FTE position.

 

[Merovinge]

Is this insurance based or a cash RTC? That makes a significant difference. Patients need to be seen within 2-3 days of admission by the psychiatrist and this is not a flexible requirement so unless they are holding onto beds for your schedule you will need to have flexibility with when you do the initial evals. I am also a little confused why a team running an IOP would add a tiny RTC before a PHP. The ideal scenario is stepping your patients down to your own treatment center after RTC and the overwhelming majority of folks need a PHP following RTC.

 

[jbomba]

Is this insurance based or a cash RTC? That makes a significant difference. Patients need to be seen within 2-3 days of admission by the psychiatrist and this is not a flexible requirement so unless they are holding onto beds for your schedule you will need to have flexibility with when you do the initial evals. I am also a little confused why a team running an IOP would add a tiny RTC before a PHP. The ideal scenario is stepping your patients down to your own treatment center after RTC and the overwhelming majority of folks need a PHP following RTC.

This will be a mix of insurance and cash. The majority will be cash. The IOP functions more like a PHP in my opinion. It's not associated with a hospital but it is 9-5, five days a week. This contrasts with most of the IOPs I've seen which are 3ish hours a day, 4 days a week.

I'm aware of revenue for each patient and will generally be around 60k per patient per month.

 

[Merovinge]

This will be a mix of insurance and cash. The majority will be cash. The IOP functions more like a PHP in my opinion. It's not associated with a hospital but it is 9-5, five days a week. This contrasts with most of the IOPs I've seen which are 3ish hours a day, 4 days a week.

I'm aware of revenue for each patient and will generally be around 60k per patient per month.

Oh, that's a PHP by definition. I guess when people are paying cash the difference is not relevant, but from an insurance perspective that would be a PHP. I would just make sure the scheduling works for you and probably charge by the hour (so you can get reimbursed for staffing and work you do with the staff as well as spend longer with patients). For this type of high cost patients, I would certainly be charging a normal cash pay psychiatric rate for your area which I assume is at least $500-600.

 

[jbomba]

Oh, that's a PHP by definition. I guess when people are paying cash the difference is not relevant, but from an insurance perspective that would be a PHP. I would just make sure the scheduling works for you and probably charge by the hour (so you can get reimbursed for staffing and work you do with the staff as well as spend longer with patients). For this type of high cost patients, I would certainly be charging a normal cash pay psychiatric rate for your area which I assume is at least $500-600.

My thought was 500/hr, figure 12 hours of intakes, 10hrs follow ups. 12k for patient care and figure another 6 hours for ancillary meetings/care coordination.

So about 14k a month for 7 hours a week.

 

[Merovinge]

My thought was 500/hr, figure 12 hours of intakes, 10hrs follow ups. 12k for patient care and figure another 6 hours for ancillary meetings/care coordination.

So about 14k a month for 7 hours a week.

That sounds right, so start at 600/hr in the negotiations.

 

[jbomba]

Thanks for the input, that is helpful