Over the past few years, PYA has assisted a number of clients with developing various types of physician call pay arrangements coupled with fair market value compensation. Whether your organization is currently paying for emergency room call coverage or just considering implementing such an arrangement, an understanding of some of the current practices and trends with respect to on-call pay could be helpful in managing physician call pay negotiations and contract compliance risk for your organization.
While a plethora of information exists within the various physician call pay surveys that are available, including types of and payment rates for a variety of call pay arrangements, several PYA call pay experiences may also be of interest to you. For example, did you know?
- There are a number of different methods hospitals utilize to pay physicians to take emergency room call. However, the “per diem” method remains the most prevalent.
- In addition to a “per diem” payment by the Hospital for emergency room on-call pay, most non-employed physicians are retaining the professional fees generated while on-call. Furthermore, some clients are choosing to put a portion of the “per diem” at risk to ensure certain quality metrics are achieved.
- Given that most organization’s medical staff bylaws require physicians to take emergency department call, call is generally more frequent than one in four nights before any call pay is considered.
- In addition to considering national benchmark call pay survey data, there are a number of factors which can impact on-call rates, including but not limited to: local market rates; frequency of call; severity of illness encountered while treating patients; likelihood of having to respond when on-call; degree of inpatient care required; payor mix; and malpractice risk.
- Given recent advisory opinions on call pay practices, more hospitals are now requiring physicians to document: the number of phone calls received while on-call; the number of visits they receive while on-call; and the number of surgeries they perform. Often included is the time incurred for each of these activities as well.
These experiences, along with the on-call rates presented in various physician call pay surveys, can be helpful information as your organization considers renewing or initiating a call pay arrangement. In particular, this information (as well as a thorough understanding of the facts and circumstances specific to your situation) can help your organization develop a contract compliance program which, among others, helps document agreements which are both at fair market value and commercially reasonable.
To discuss emergency room call coverage trends, fair market value compensation, or commercial reasonableness for emergency room call coverage services, please contact the experts listed below at PYA, (800) 270-9629.
