AMFMM Benchmarking Data,

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1 C APPENDIX AMFMM Benchmarking Data, Brian Iriye, MD, Chairman, AMFMM The data presented in this appendix are the results of the largest survey ever conducted to acquire facts that are specifically about the practice of maternal-fetal medicine (MFM). Collated in late 2010 and early 2011, this detailed information was gathered by the Association for Maternal-Fetal Medicine Management (AMFMM) from 50 member practices that represented 209 MFM physicians throughout the United States. It is through the work of the Society for Maternal-Fetal Medicine (SMFM) that a practice management organization was specifically created. AMFMM is pleased to present the following benchmarking material within this important work that chronicles the history of our specialty, and we hope the information in this survey will be extremely valuable for both AMFMM and SMFM members. APPENDIX C 119 SMFM Appendices R2.indd 119

2 Study Demographics For the study, questionnaires were sent to 50 physician practices that involved 209 doctors. Q. which of the following best describes the classification of your organization? 28% 2% 40% Hospital-owned practice Private medical practice (solo or group) Nationally owned medical practice (Obstetrix, etc.) Academic practice (clinical science department, faculty practice plan) 32% Q. Can you specify the region of your practice? Northeast Division 1 ME, NH, VT, MA, RI, CT Northeast Division 2 NY, PA, NJ (14%) Midwest Division 3 WI, MI, IL, IN, OH (16%) Midwest Division 4 MO ND, SD, NE, KS, MN, IA Region South Division 5 DE, MD, DC, VA, WV, NC, SC, GA, FL South Division 6 KY, TN, MS, AL South Division 7 OK, TX, AK, LA West Division 8 ID, MT, WY, NV, UT, CO, AZ, NM (24%) West Division 9 AK, WA, OR, CA, HI Years of Leading Maternal and Fetal Care SMFM Appendices R2.indd 120

3 Physician Information Q. what is the number of full-time MFM physicians (working 4 days per week or more excluding call weekends)? Please count days worked in both clinical and nonclinical capacity (such as teaching, research, and administration). Number of full-time MFM physicians (16%) (22%) All other responses Division Northeast Division 1 Northeast Division 2 Midwest Division 3 Midwest Division 4 South Division 5 South Division 6 South Division 7 West Division 8 West Division 9 Q. what is the average number of patients seen per physician per full workday in the clinical office? (Data exclude antepartum testing patients.) Number of patients seen per physician (14%) (16%) (28%) Q. what benefits do your doctors receive besides salary? Please check all that apply. Cell phone service cost (68%) As a result of the survey, physician salary information can be broken down as follows: Average salary $471,377 Median salary $410,625 10th percentile $240,000 25th percentile $300,000 75th percentile $535,000 90th percentile $714,420 Benefits Pager service cost Continuing medical education allowance Health insurance Dental insurance Optical insurance Retirement funding such as 401k, profit sharing, life insurance, etc. Professional organization dues (72%) (92%) (90%) (82%) (64%) (94%) (82%) APPENDIX C 121 SMFM Appendices R2.indd 121

4 Q. does your practice have a bonus structure for physicians beyond salaried compensation? A. among the respondents, 64 percent replied yes, and 36 percent replied no. Q. which factors are bonus structures based on, and what are their influences on the amount of bonus compensation? Number of respondents % (2) 3.1% (1) 29.9% (7) 68.8% (22) 0 Clinical production (relative value units or charges/ collections) No effect Minor influence 50.0% (15) 20.0% (6) Patient satisfaction surveys 64.3% (18) 64.3% (18) Research or publications Moderate influence Major influence 57.1% (10) 7.1% (10) 23.3% (7) 25.0% (7) 25.0% (7) 35.7% (10) 3.6% (1) 6.7% (2) 10.7% (3) 7.1% (2) Seniority Call hours Q. do your physicians provide 24-hour, in-house call to any facilities? A. among the respondents, 54 percent replied yes, and 46 percent replied no. Q. How many hospitals does your practice service? 6% (3) 10% (5) 2% (1) 2% (1) 4% (2) 6% (3) 32% (16) 38% (19) Number of hospitals Q. are your physicians or practice compensated (through either a directorship or a nightly wage) for providing at-home, 24-hour call to hospitals? 8.7% (4) 4.3% (2) 6.5% (3) 28.3% (13) 52.2% (24) At no hospitals At all hospitals At 50 74% of hospitals At 25 49% of hospitals At 1 24% of hospitals Q. do your physicians provide at-home, 24-hour call to hospitals. A. among the respondents, 96 percent replied yes, and 4 percent replied no Years of Leading Maternal and Fetal Care SMFM Appendices R2.indd 122

5 Q. does your practice have directorship agreements with the hospitals it works at? A. among the respondents, 38 percent have such agreements at all hospitals, 36 percent have agreements at no hospitals, and 26 percent have agreements at some hospitals. For those practices that are receiving yearly directorship payments, the compensation is as follows: Average payment $132,439 Median payment $73,500 25th percentile $40,000 75th percentile $175,000 Q. is your practice one that is consult only (no deliveries)? A. among the respondents, 58 percent replied no, and 42 percent replied yes. Q. does your practice perform deliveries, and, if so, how many per doctor on average per year? 1 25 (6.9%) Office Scheduling Q. what is the average number of patients seen per physician per full workday in the clinical office? (Exclude antepartum testing patients.) Number of patients (14%) (16%) (28%) Q. how many minutes do you schedule for a new consultation? (20.7%) (30%) Number of deliveries (10.3%) (10.3%) (6.9%) (13.8%) (22%) (32%) Greater than 200 (10.3%) (20.7%) APPENDIX C 123 SMFM Appendices R2.indd 123

6 Q. how many minutes do you schedule for an established office visit only? Q. how many minutes do you schedule for only? (24%) (44%) (20%) (50%) Not applicable Q. how many minutes do you schedule for a only? Q. how many minutes do you schedule for only? All other responses (34%) (22%) (22%) (20%) (44%) All other responses Years of Leading Maternal and Fetal Care SMFM Appendices R2.indd 124 1/18/13 12:14 PM

7 Q. how many minutes do you schedule the ultrasound-only components for first trimester genetic screening (76801 and 76813)? Office Space Q. how many clinical offices does your practice have? All other responses (50%) Number of offices 1 (38%) 2 (26%) 3 (20%) 4 (10%) Sonographer Work Q. do your sonographers routinely perform biophysical profiles? A. among the respondents, 82 percent replied yes, and 18 percent replied no. Q. what is the average number of ultrasounds done per sonographer in an 8-hour workday including biophysical profiles? If the workday is longer or shorter, please average out for an 8-hour workday. Average 11.4 Median th percentile 9 75th percentile 12 Q. what is the average number of ultrasounds done per sonographer in an 8-hour workday excluding biophysical profiles? If the workday is longer or shorter, please average out for an 8-hour workday. Average 9.84 Median 9 25th percentile 8 75th percentile 11 Q. do you own or lease your office space? A. among the respondents, 78 percent lease office space, 14 percent own the space, and 8 percent have a mixture of both. Q. how much office space do you have per doctor? Average 1,904 sq. ft. Median 1,500 sq. ft. 25th percentile 1,026 sq. ft. 75th percentile 2,400 sq. ft. Ancillary Personnel Q. Does your practice employ nurses? A. among the respondents, 88 percent replied yes, and 12 percent replied no. Q. does your practice personally employ genetic counselors? Do not count services provided by an outside agency such as Genzyme as personally employed. A. among the respondents, 52 percent replied yes, and 48 percent replied no. APPENDIX C 125 SMFM Appendices R2.indd 125 1/18/13 12:14 PM

8 Q. what is the average number of patients seen by a genetic counselor per day (in practices that hire genetic counselors)? Average 4.7 Median 4 25th percentile 4 75th percentile 5.5 Q. what is the average genetic counselor wage in practices hiring a genetic counselor? Average $57,598 Median $60,000 25th percentile $51,188 75th percentile $63,459 Practice Manager Q. what is the percentage of your overhead expenses? Average 50.7% Median 50.0% 25th percentile 39.0% 75th percentile 59.0% Q. what the salary of your practice manager? Average $80,418 Median $75,000 25th percentile $56,520 75th percentile $92,000 Q. does your practice provide diabetic education services performed by nonphysicians? A. among the respondents, 63 percent replied yes, and 37 percent replied no. Q. does your practice employ a certified diabetic educator for diabetic services? A. among the respondents, 57.5 percent replied no, and 42.5 percent replied yes. Electronic Medical Record (EMR) Q. Does your practice use an EMR? A. among the respondents, 68 percent replied yes, and 32 percent replied no. Q. Which EMR does your practice use? Billing Information Q. Does your practice employ a certified coder? A. among the respondents, 78.4 percent replied yes, and 21.6 percent replied no. Q. is your medical billing done in house or outsourced? A. among the respondents, 68 percent billed in house and 32 percent outsourced. Q. what is the percentage of practices that use an outside billing company? Average 6.79% Median 6.0% 25th percentile 5.0% 75th percentile 8.0% EMRs Allscripts Epic Centricity Nextgen eclinicalworks Greenway e-mds Practice Partner (7.1%) (7.1%) (3.6%) (3.6%) (3.6%) (17.9%) (25.0%) (32.1%) Q. how many billers do you have per doctor in practices that are performing their own billing? Average of 0.6 billers per doctor Years of Leading Maternal and Fetal Care SMFM Appendices R2.indd 126 1/18/13 12:14 PM

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