Consulting Principals Angie Caldwell and Sarah Bowman recently wrote an article published by the American Association of Provider Compensation Professionals (AAPCP). The article, “Is Chronic Care Management Chronically Impacting Your Employed Provider Productivity?,” examines the collaborative nature of the physician, nonphysician practitioner (NPP), and clinical staff when providing chronic care management (CCM). It describes the impact of chronic care and similar care management services on physician compensation models and presents scenarios for valuing the impact.
Caldwell and Bowman write,
“While the wRVUs assigned for CCM services are intended to account for the billing (supervising) practitioner’s involvement in CCM services, some organizations are concerned that the wRVU assigned is not weighted commiserate with the true allocation of work personally performed by the provider versus the clinical staff. Additionally, organizations may face situations where expenses paid per CCM service (clinical support costs, provider wRVU compensation, etc.) exceed reimbursement, creating an unintentional deficit.”
The authors provide two illustrated and easy-to-administer scenarios that address the services rendered vs CPT billing concerns:
- Option 1: The health system removes wRVUs generated from related CPT codes from the physician’s productivity and instead pays a CCM oversight stipend
- Option 2: The health system includes wRVUs generated from related CPT codes but pays a reduced conversion factor for the CCM wRVUs
The full article was published in the Nov. 12, 2024, issue of the AAPCP newsletter, where it is available to AAPCP members and subscribers. View a PDF of the article.
This is the third in a 2024 series of PYA articles related to physician compensation design, planning, and valuation that was published in the newsletter. Read PYA’s additional thought leadership:
- Considerations for Valuing Post-Operative Services in Optometry Co-Management Arrangements
- Addressing the 2024 Physician Fee Schedule – Key Updates and Adjustments
The AAPCP is the largest nonprofit organization in the country devoted to provider compensation, contracting, and alignment. The organization’s members advise and lead organizations on provider compensation, contracting, planning, recruitment, retention, strategy, and valuation.
For additional guidance related to provider compensation design or any matter related to fair market value compensation, valuation, compliance, or strategy and integration, our executives are happy to assist.
