What kinds of 'golden handcuffs' does your group have? We are negotiating...

[Red Runner]

So our hospital employed group is in the process of re-negotiating our contracts. This presents us with the opportunity to create some "golden handcuffs" and to negotiate for fair incentive/bonus compensation structures? What kinds of compensation besides the hourly wage and productivity models do you have or are you aware of. I'm not necessarily interested in an exhaustive list so much as I am in the ones you find particularly helpful and the ones you might find particularly onerous.

For example:

We know they will require a patient satisfaction component. How have you structured this to protect your group from competing with each other and from 100% satisfaction as the goal? What has worked well for your group?

How is your retirement plan structured to reduce your pretax income and maximize your retirement savings?

Any help is much appreciated. We don't imagine we will get this opportunity often but we are putting up some awesome numbers and so they are actually asking for our input on this contract. Thanks in advance!

---

Members don't see this ad.

 

[Red Runner]

No replies?

It doesn't have to be your current employer or even your contract? Anyone willing to share what they love or hate about incentive plans in contracts they are aware of?

Most ED contracts today, from my limited knowledge, seem to have more than just hourly wages or RVU production? It also seems that if health reform continues along its current path we will all be faced with structuring incentive packages within our contracts designed to assure we work with the hospitals to accomplish goals other than just seeing patients as this will no longer be enough to maintain our income and the hospitals financial stability. Especially for those hospitals who are beginning to go down the path of "bundled payments"

Thanks for reading and for any thoughts.

 

[Birdstrike]

.

 

[deleted109597]

-We are all atls, pals, acls certified.

Agree with everything but this.
The merit badges do not make a physician. BC makes the physician. Nurses get merit badges.
Even the ACS thinks we don't have to renew ATLS as long as we had it during residency. The college as a whole should support this endeavor, but I doubt they will, as FM docs probably should have to take those courses.

 

[Birdstrike]

.

 

[edgesofsanity]

I think this is a great topic for talking about issues, but the best piece of advice I have for you is to email your residency program and find out if there are any former residents who are now directors of ERs - people with whom you can discuss intimate details. These folk will be your best bet regarding what works and more importantly, what doesn't.

 

[Red Runner]

I think this is a great topic for talking about issues, but the best piece of advice I have for you is to email your residency program and find out if there are any former residents who are now directors of ERs - people with whom you can discuss intimate details. These folk will be your best bet regarding what works and more importantly, what doesn't.

I'm aware individuals don't want to post intimate details and I'm not necessarily after that but the landscape is changing quickly with healthcare reform. Our system is forming an ACO. We are participating in bundled payments for some diagnosis in 2013. All systems are facing the Medicare and Medicaid Readmission clawbacks/reductions in payment. The fact is that what we used to do with regards to contracts is going to need to change. Happy customers, increasing visits, and more RVU's are not going to be the only way to make money and in fact, increasing visits in an ACO model may lead to declining revenues in some cases. We are a very successful hospital employed group and we want our incentive structure going forward to reward us for our innovations, our commitment to quality, and our willingness to work with administration. Because we have hit the traditional metrics you speak of we are being asked to help design the future rather than being presented with something and asked to "take it or leave it". I have some thoughts on what we will likely ask for but was interested if anyone else had something they knew of that made that particular package unique or worthwhile. For instance - I did not like the group I worked with that changed the benchmark for Pt Sat and for Productivity based on the average of the group. As the group improves the bottom % of the group gets left out of bonus even thought they are now above national standards and by most observers would be excelling at these metrics. The incentive should be written in such a way as to never penalize success in my opinion. Anyone else?