PHYSICIAN COMPENSATION PLAN DESIGN STRATEGY

Transcription

1 April 17, 2014 PHYSICIAN COMPENSATION PLAN DESIGN STRATEGY Mark Blessing, CPA, FHFMA Partner Randy Biernat, CPA, ABV Directr TO RECEIVE CPE CREDIT Individual Attendee Participate in entire webinar Answer plls when they are prvided Grup Attendees Cmplete grup attendance frm with Title & date f live webinar Yur cmpany name Yur printed name, signature & address All grup attendance sheets must be submitted t [email protected] within 24 hurs f live webinar Answer plls when they are prvided If all eligibility requirements are met, each participant will be ed a CPE certificate within 15 business days f live webinar 2 1

2 INTRODUCTION Framewrk fr change Cmparisn f cmmn cmpensatin arrangements Cmpensatin as a tl t drive change 3 PHYSICIAN COMPENSATION IN THE HEALTH REFORM ERA COPING WITH CONSTANT CHANGE 4 2

3 NAVIGATING HEALTH REFORM Next Generatin Cmpensatin Plans Generally matches the financial realities f tday (fee fr service) fr majrity f cmpensatin Encurages skills needed fr tmrrw, including prviding sme rewards fr managing patient care, imprving safety, patient satisfactin, etc. 5 FINANCIAL ALIGNMENT Next Generatin Cmpensatin Plans We are bserving that new cmpensatin plans link 60% - 80% f cmpensatin t traditinal wrk effrt measures, linked as clsely as pssible t hw services are actually reimbursed by insurers Reality is that prviders tend t relate well t actual payment mechanisms f verall grup Prviders als are typically nt pleased t hear they are a net drain n financials 6 3

4 MISSION ALIGNMENT Next Generatin Cmpensatin Plans We are bserving that new cmpensatin plans link 20% - 40% f cmpensatin cnnected t nntraditinal prductivity measures f physician wrk effrts Cnsider items Patient safety Patient satisfactin Adherence t standard f care prtcls Management participatin Miscellaneus citizenship items 7 PATHWAY TO CHANGE (WHY CHANGE?) Intent is rted in missin/visin/values Designed t create enduring sustainability Guided by need t adapt t health care refrm 8 4

5 MAJOR PLAN DESIGN OPTIONS THERE ARE MANY WAYS 9 COMPENSATION PLANS COMPARED Key Factrs Incentivizes Prvider Prductivity Prvider Bears Payr Mix Risk Has N Inherent Fee Setting Cnstraint Rewards Keeping Practice Csts Lw Easy fr Management t Administer Matches Practice Incme Methd Incentivizes Prviding Access t Care Incentivizes Practice Prfitability Rewards Patient Visit Efficiency Rewards Quality Outcmes Rewards Patient Safety Rewards High Patient Satisfactin Salary % Charges % Cllectins Rev. - Exp. WRVUs Per Encunter PMPM Star Rating Key Pr Fair Gd Excellent 10 5

6 KEY FACTORS DEFINED (1/4) Incentivizes Prvider Prductivity methd f cmpensatin has a direct crrelatin t prvider prductivity Payr Mix Risk Matches Practice s cmpensatin methdlgy des nt insulate prvider frm payr mix risk Has N Inherent Fee Setting Cnstraint cmpensatin mechanism is nt designed such that changes in fee structure will drive a crrespnding change in prvider cmpensatin 11 KEY FACTORS DEFINED (2/4) Rewards Keeping Practice Csts Lw sme element f cst (&, therefre, prfit) is a fundamental feature f cmpensatin plan Easy fr Management t Administer rates actual expected pain t manage & administer cmpensatin plan Matches Practice Incme Methd this gets t matching principle f aligning prvider cmpensatin t practice reimbursement mechanisms 12 6

7 KEY FACTORS DEFINED (3/4) Incentivizes Prviding Access t Care prvider cmpensatin plan has an inherent incentive fr prviders t see mre patients/be mre available fr care Incentivizes Practice Prfitability direct link in plan exists between verall success f practice & prvider cmpensatin Rewards Patient Visit Efficiency elements that create an incentive t make patient visits quick & efficient 13 KEY FACTORS DEFINED (4/4) Rewards Quality Outcmes plan has incentives arund measurable quality factrs Rewards Patient Safety plan elements that create incentives t create r maintain high level f patient safety Rewards High Patient Satisfactin cmpensatin mechanisms that pay prviders fr achievement arund patient safety measures 14 7

8 EIGHT STEPS TO SUCCESS COMMITTED TO PROCESS & NO SURPRISES 15 STEP 1: BENCHMARKING Fr each prvider, benchmark charges, cllectins, WRVUs, cmpensatin & net incme, as well as sme key relatinships between these pints (i.e., cmpensatin t cllectins rati) Dcument results f a benchmarking exercise This creates a baseline fr cmparing & cntrasting impact f ptential new plans 16 8

9 STEP 2: INTRODUCE NEW PLAN DESIGN CONCEPTS TO PROVIDERS Kick-ff meeting with prviders Intrduce prviders t general cncepts t be explred in develping a new physician cmpensatin plan Establish a cnnectin t utcme & lay fundatin fr general gals & principles t be fllwed in redesign prcess Key items t include General update n state f health care General results f benchmarking exercise Prs & cns f three r fur pssible plan philsphies Overview f general design & implementatin prcess Materials & delivery shuld fcus bth n a cllabrative prcess as well as a cmpliant mdel/utcme 17 STEP 3: WRITTEN PROCESS COMMITMENT Dcument & share prcess t be fllwed Imprtant prcess elements include Key milestnes Cmmitments made in the kick-ff meeting (such as data sharing, nnstarters, key elements agreed t) Meeting dates Key respnsible parties Pints f general feedback This will be memrializatin f mutual cmmitments made in kick-ff meeting & is imprtant in establishing expectatins & accuntability 18 9

10 STEP 4: PHYSICIAN INTERVIEWS Slicit individualized feedback (bth psitive & negative) Educate prviders by answering specific questins & cncerns Prvides a real sense f what will & will nt wrk fr a particular grup f prviders 19 STEP 5: SCENARIO ANALYSIS Mdel ut a baseline scenari cmpared t histrical Mdeling is recmmended t be dne after there is buy in t the cnceptual changes 20 10

11 STEP 6: PRESENTATION OF RESULTS TO DATE Dcument & present key wrk perfrmed, including Final cncepts Befre & after scenari results Cmpensatin calculatin & payment mechanics Next steps & timing This is 80% cmplete marker 21 STEP 7: WORKING GROUP FINALIZATION Select key leaders & technical experts t finalize pen details Reslve pen items/issues raised at general presentatin f results t date T accept change, prviders will need t Understand data elements utilized Trust data t be cmplete & accurate Becme cmfrtable with nging internal cntrls related t all cmpensatin data elements Intended utcme f this step is t dcument Key plan principles (in writing) Surces f infrmatin used in mdel Updated sample cmpensatin calculatin Implementatin timeline details 22 11

12 STEP 8: IMPLEMENTATION New cntracts need t be drafted, apprved & signed Cmpensatin plan details will need t be cmmunicated with finance staff New r revised cmmunicatins abut physician results will need t be develped & deplyed Updates shuld be made t written internal cntrls plicies 23 PRO-TIPS FIVE INSIGHTS ON MAKING IT WORK 24 12

13 PRO-TIP #1 When cnsidering utilizatin f nnprductivity measures, cnsider utcme versus prcess rewards Outcmes riented prvider is held accuntable (& cmpensated) based n an actual tangible, measureable result Prcess riented prvider is held accuntable (& cmpensated) based n cmplying with an agreed-upn prcess that is integral in achieving desired utcme Fr example, cnsider Smking cessatin Patient satisfactin 25 PRO-TIP #2 Cnsider a better f adjustment perid There will be kinks t wrk ut with mst new systems. This creates uncertainty in prviders &, therefre, a hesitancy t adpt a new system T cmbat uncertainty, utilizing a grace perid f three t nine mnths prvides management & physicians an pprtunity t ease int new plan with sme understanding that pain f change will be blunted by design 26 13

14 PRO-TIP #3 Utilize a sliding scale fr nnprductivity incentives Helps with frustratins frm falling behind early Rewards effrt, even shrt f ideal utcmes 27 PRO-TIP #4 Build emplyment cntract fr change By structuring emplyment cntract t refer t a cmpensatin plan set at management s discretin, emplyers avid needing t frequently rewrite & resign emplyment cntracts Especially if nnprductivity elements are included in cmpensatin plan, plan shuld really be built t change & be updated & recalibrated based n success r failure f certain initiatives 28 14

15 PRO-TIP #5 T cmbat physician turnver, create and fund retentin bnus pls Bringing this element int the annual review prcess can help with a frank dialgue n happiness, career intentins, and verall expectatins An advanced retentin fund can be creatively structured and payments can be made fr a variety f achievements r milestnes 29 QUESTIONS? 30 15

16 CONTINUING PROFESSIONAL EDUCATION (CPE) CREDITS BKD, LLP is registered with the Natinal Assciatin f State Bards f Accuntancy (NASBA) as a spnsr f cntinuing prfessinal educatin n the Natinal Registry f CPE Spnsrs. State bards f accuntancy have final authrity n the acceptance f individual curses fr CPE credit. Cmplaints regarding registered spnsrs may be submitted t the Natinal Registry f CPE Spnsrs thrugh its website: The infrmatin in BKD webinars is presented by BKD prfessinals, but applying specific infrmatin t yur situatin requires careful cnsideratin f facts & circumstances. Cnsult yur BKD advisr befre acting n any matters cvered in these webinars. 31 CPE CREDIT 1 CPE credit may be awarded upn verificatin f participant attendance Fr questins, cncerns r cmments regarding CPE credit, please the BKD Learning & Develpment Department at [email protected] 32 16

17 THANK YOU Mark Blessing, CPA, FHFMA Partner Randy Biernat, CPA, ABV Directr