On-Demand Webinar: “Strategically Aligned Provider Compensation Models: They Just Make Sense (and Cents)”

Strategically Aligned Provider Compensation Models: They Just Make Sense (and Cents) | July 22, 2025

Presenters: Angie Caldwell, CPA, MBA, and Ericka Dickinson, MHA, CAPM

This transcript was generated with AI and may contain errors or omissions. Please refer to the webinar recording for the most accurate version.

Timestamped section headings are editorial navigation aids and are not part of the spoken transcript.

00:20 – Introduction and presenters

PYA Moderator [00:20]: Good afternoon everyone. Welcome to today’s webinar. Strategically Aligned Provider Compensation Models: They Just Make Sense (and Cents). PYA is happy to present today’s webinar on this important topic. You may submit questions during the webinar by typing a message into the Q&A pane of the control panel. Also immediately following the end of the webinar, you’ll be asked to complete a short survey and submit any additional comments, any questions not responded to during the webinar will be responded to via email after the webinar, we’ve posted a PDF copy of the presentation slides for your reference in the resources pane, you can customize your viewing experience by resizing, moving or minimizing all of the panes within the webinar.net platform, you’ll receive an email later today with a copy of the slides and a recording of the webinar. With that, I’d like to introduce our presenters, Angie Caldwell and Ericka Dickinson.

01:34 – Organizational impact and strategic alignment

Angie Caldwell [01:34]: Thank you so much, Jennifer and good afternoon everyone. We have a few learning objectives today regarding our topic, strategically aligned compensation models. First, we want to provide some information to you about how your organization may be impacted by a strategically aligned compensation model, all good things. Of course, strategic alignment is in the good camp. And so we want to talk about the good things that could happen or could come about. We want to help you understand how you might be able to enhance recruiting efforts when you align your compensation model strategically. Third gain improvement in retention and satisfaction rates, which is very important today and in the environment that we’re operating in, and then lastly, assess methods to operationalize alignment. So let’s get into it. So I’m going to spend a few minutes on this slide. So please don’t be alarmed, but when we think about the organizational impact of a strategically aligned compensation model on the screen in front of you are several elements that as organizations you are thinking about every single day, provider shortages, provider burnout, patient expectations, reimbursement, payer reimbursement, shift towards value-based care and, of course, legislative changes. So if all of these things are the factors that are impacting you as an organization strategically, then all of these things should be thought of and strategically and strategically thought through with tactics to address within your compensation model. So your compensation plan shouldn’t be more complicated. In fact, every single day we hear, I want more simplicity. I want consistency, and I want more alignment within my compensation plan, all three of those key tenets fit within a strategically aligned compensation model. Of course, if you don’t align your compensation plan strategically, each of these elements can become a negative for your organization, right? And not to think about and hone in on the negatives you know, provider shortages. Let’s think about how it might affect you if your compensation plan isn’t addressing provider shortages. So your compensation plan needs to be aggressive, and if it is, you’re able to recruit and retain the talent that is available to you in this environment of provider shortages. We’re going to talk about that a little bit more here in depth in a moment. But your compensation plan should address burnout, and how is that? So, you know, there’s actually a survey out there that specifically addresses the elements of physician burnout, and physicians talk about how they feel like they’re tied to their computers and they have to click and work through so many things from a paperwork perspective that they’re not able to really do what they went to medical school to do, which was to help the patient and spend time and build a relationship with the patient. So a strategically aligned compensation plan should help address this time element and help the physician with that need to spend more time with the patient. Patient expectations: let’s talk about that. So we have as a patient, I want to spend more time with my physician, not less, and I want to be able to access my physician more quickly. So strategically, a compensation plan should address these patient expectations. What does the plan do to allow the physician to spend more time with the patient. And I know that the other side of that, of course, is well, then the collections aren’t there. We have to have a certain number of collections to be able to run this business. But from a patient expectation perspective, there is a balance there between how the physician is paid and what the patient expects. And then also from an access perspective, the physician being available to the patient. So we’ll talk about that more in just a moment, payer reimbursement in our environment, everyone is concerned. We’re going to talk about the one big, beautiful bill here in a moment. You know, payer reimbursement continues to decline, or be at risk of declining, and so that’s something that we always want to keep in mind when thinking about a strategically aligned compensation model, the shift towards value-based care. Hopefully we’ll have a moment to talk about team a little bit later, just related to all of the various and different value based methodologies that are coming through our payers and how can you align that within your strategically aligned compensation model? You don’t want to forget that the way the organization is reimbursed should align to the fullest extent with the way the provider is paid. It makes more sense economically to do it that way. So we can talk about that a little bit more as well, and, of course, legislative changes, which I’ve already mentioned, we’re going to we’re going to hit on that. So let’s talk about provider shortages in some more detail. So this is a wonderful graph put out by our friends at the AAMC. And we all feel this. So I am going to admit that I’m not telling you anything that you don’t already know on this slide, we are all feeling the physician shortfall in our environment. We can tell from just the recruiting challenges that organizations are facing. We can tell personally when we’re trying to get an appointment with a specialist. In the market, there is a well known and well documented physician shortfall. According to this graph, it doesn’t look like that’s going to get better anytime soon. So to help with understanding this graphic a little bit, if you’re reading it from left to right. Left is where we are today, or close to where we are today. We are already showing a significant shortfall of thousands of physicians. And then the top dotted line indicates the worst case scenario, meaning it could be much worse than it is today, or, with an abundance of optimism, the bottom line indicates the shortfall may not be as severe, I think, you know, as we all sit here and we are absorbing the environment that we’re in and we’re absorbing some of the regulatory pressures that we’re feeling in the healthcare industry, my sense is that the lower line is probably not where we’re going to end up. I would like to be optimistic and say that we will, but hopefully we can do something within the industry to help eliminate or help to ease this shortfall a bit. So with that shortfall in mind, let’s talk strategically about recruiting providers to your organizations. Many or most medical students and physicians coming into your organizations have student loans. In fact, the AAMC says that 70% of medical students graduated with student debt in 2023 and that debt, it’s not just a little bit, it’s a lot. It’s somewhere between $200,000 and $300,000 per medical student

09:31 – Medical student loans, recruiting, and retention considerations

Angie Caldwell [09:31]: And this amount of debt adds to the stress of the physician coming out of school and coming into their role, knowing that they have that debt to pay back. I think about a medical student coming out with that kind of a debt load and trying to start up a new practice that is a huge stressor to a new physician in the market, and something that, from a recruiting standpoint, perhaps there is a strategy here that we can we can help organizations with and help organizations think through. If you think about the One Big Beautiful Bill. Beginning next year, July 1, 2026 there is a new cap, or a new maximum amount for federal student loans of $200,000 for professional students. I’m going to talk about the total cap here in a minute, but the $200,000 cap is for professional students, including medical students. That’s a decrease of about 11% so you might hear 11% and that decrease, and quickly do the math, and, oh, that’s about $24,000 to $25,000 right? So then, you know, you might be thinking, but Angie, is that really that big of a deal? You know, it’s 11%; they’ll get the $200,000, and everything’s going to be just fine. But if you think about $24,000 in the interest on that over a number of years, it could be enough already for someone thinking about the amount of time in medical school, the amount of time, the amount of stress coming out of medical school, paying back a loan, and all the other things that perhaps this is the tipping point to make a student choose a Career other than medicine. So from a recruitment perspective and perhaps a retention perspective. What can organizations do to help with this student loan burden? First of all, we know that many of you have medical student loan repayment programs that you’re already offering, but with the cap that we’ll talk about here in a moment, with the cap that’s coming up, are there other things as an organization that you could perhaps do to help ensure that your students coming to your organization are getting that financial help sooner? And I know that is a burden, that would be another financial burden to an organization, but one that is important to think about, because, of course, one of the tactics that we’re seeing across the country that has had some success, is the earlier you’re able to recruit to an organization, whether that’s through a nursing program or another Allied Health Professional Program, or even in a medical student or a physician program, the earlier you are able to start that recruitment process and create that home, if you will, for that student. Then perhaps that’s just another way that you can help with that recruitment and retention. So what I’m suggesting is perhaps there is an opportunity within your student loan repayment programs to create a partnership with a credit union with a private lender, so that there is an opportunity to make sure that the students are getting the money that they need to be able to complete their education. So further related to medical student loans, and we’re still talking about one big, beautiful bill, as we all continue to do, there is a lifetime cap on these federal student loans as well. So while the cap, the maximum for professional loans is $200,000. The lifetime cap on all federal student loans is $257,500, so that is not much more than what’s available under the professional portion of this so again, that kind of continues to illuminate the need to help these students. And we also heard on the previous slide that medical students have up to $300,000 in medical school debt. So you can already see there is a difference between what’s available federally and what might have to be funded privately. So also related to one big, beautiful bill, early on in the process, there was some talk about removing the repayment and the forgiveness provisions that are allowed under certain of those loans. Please know that one big, beautiful bill passed without removing those provisions, so that provision is safe, Some qualifying organizations continue to be able to offer that forgiveness as it relates to those certain types of loans. But if you think about again, just the total amount of debt outstanding needed, and that the cap still exists, especially in rural markets. This whole cap and this unavailability could create some pressures, especially in rural environments, which may draw international physicians to those markets. And just again, the availability of the of the physicians in general. So this could be creating some pressure for our rural colleagues in rural areas. So again, touching on recruiting and retention, a strategically aligned compensation plan should focus on what the one big, beautiful bill impact will be on immigration policy, specifically as we think about the physician shortage and visa restrictions and J-1 programs, all of these items are likely immigration concerns, a limited number of students, a limited number of folks coming in, which could further create a shortage issue as it relates to physicians. But to put a finer point on that, not only physicians, but perhaps nurses, home health workers, you know, others in the physician practice as well, that we need to think about from a strategy perspective. So with that, I’m going to turn things over to Ericka to talk a little bit about retention.

16:11 – Provider retention and incentive model design

Ericka Dickinson [16:11]: Great. Thanks, Angie. Yes. So Angie’s talked some about recruitment, but unfortunately, that is only one piece of the puzzle when we’re talking about strategically aligned compensation models. So the provider shortages that we’ve talked about today, they’re no secret in our industry. We’ve been experiencing them, we will continue to experience them, and providers know about it, so they know they have the benefit of choice, and there’s a lot of opportunity and a lot of different paths out there for our provider groups. And so the next hurdle becomes retention. And so we’ve got providers in the door. How do we use that compensation model to keep them? And I don’t want to oversimplify this, so base compensation and total compensation, those numbers do matter in terms of provider satisfaction and retention rates, but we know they’re not everything, and particularly as we have younger physicians and younger APPs entering the workforce. The data is showing us that these younger generations, they have some different expectations than what we’re used to seeing. And this generation, they put some more stock into work-life balance, into autonomy and equity, and really want to have the ability to make an impact with the patients that they serve. And so because of that, and some of the other factors that Angie’s talked about today, wRVU models are really becoming outdated, if they weren’t already, and Angie and I, we aren’t campaigning to do away with the wRVU just yet. We still think it’s a crucial metric to track and to understand, to really get a feel for current trends and also work effort across your organization. But we do believe it shouldn’t be the basis of your compensation models. And so to come up with a new model, we’ve got to get a little creative. And as much as we would love to come on today and present one beautifully wrapped compensation model that you could all take and implement tomorrow, and it worked flawlessly. We haven’t quite figured out that secret sauce. And the reality is that it’s just not possible. There is not a one-size-fits-all model when it comes to compensation. And so it’s really, it has to be dependent on your individual goals and the trajectory of your organization. So first you want to try to align your compensation models with your institutional goals. So if you’re a hospital or a health system, perhaps you are more focused on patient outcomes or on access, as Angie talked about earlier, if you’re a physician owned group, perhaps you are focused on revenue and on your bottom line, and if you’re a private equity backed group, perhaps you’re focused on efficiency and on growth. And so whatever those driving factors are going to be specific to your organization, and you’ve got to build your comp plan around that. So to have a more tailored approach for your organization, we recommend exploring some different incentive options that you can include in your compensation model, but it’s very important to be transparent about what those exactly end up being. So you could consider some different quality incentives or care coordination bonuses. You could consider payment for medical directorships or for teaching or research, kind of you know what makes the most sense for your organization, and then there’s engagement and satisfaction. And so we need to be sure if we’re going to implement incentive compensation that we measure and we compensate on something that the providers can have a direct impact on so if it’s a metric that they have no control over, no influence in, for example, take an emergency medicine physician, if they were compensated on the number of patients walking in the door. Well, they can’t really have control over that. We also don’t want our communities to be sick that they’re seeking emergency care, and we don’t want to encourage our communities to use an emergency department as a safety net. And so if we compensate our emergency medicine providers on that, they’ll likely be disengaged and they’ll be dissatisfied. And so instead, we want to focus on metrics that either they can have direct control over or direct influence over to end up with more involved providers. So in our emergency medicine example, perhaps we are incentivizing on process adherence or on quality outcomes, something that they can have some more control over the output. So to your right on the screen, we have an example of a hybrid model that uses a base salary plus some incentives. And so the incentives here are patient outcomes and team performance. So the goal of this comp model is to emphasize commitment to high quality care through the patient outcome metric and long term provider and patient relationships through the team based performance metric. And then, of course, you have your more traditional recruitment and retention offerings, such as student loan forgiveness, sign on bonuses and relocation support. I’m calling them traditional because we’re more used to seeing them in our field. But as Angie pointed out earlier, you know, these have changed a lot. They take a different shape through various administrations or different federal guidance. We talked a lot about the loan and the education piece, so this has always and will always look a little bit different, but want to be sure that we mentioned them as they can still be useful strategies when trying to recruit and retain high quality providers. I touched briefly on quality on the last slide, but wanted to dig a little bit deeper with some data here. So quality bonuses are things that we’ve seen included in contracts for years, and I think it’s only becoming more and more prevalent. I know I’ve talked to several clients just in the last few weeks who are interested in adding some sort of quality component to some legacy contracts that they’ve had with group, you know, with specific groups, for decades. So I definitely see this trend continuing over time. And while the metrics may change based on specialty or again, based on whatever your organization prioritizes and is aiming to achieve, we still wanted to provide some feedback here related to quality as a percent of total compensation. So this should help give you a feel for how this might relate to your organization. So when we’re looking at median rates –

22:35 – Quality incentives and value-based reimbursement

Angie Caldwell [22:35]: I was just going to add related to this median rate across all these different physician specialties and groupings. This percentage and the dollar amount has not changed for two to three years, and some of that is related to the change management associated with implementing a compensation plan that contains quality and engagement incentives. And so while thinking to the future and thinking through the strategically aligned compensation model, this could change over time, and perhaps this is what you were getting to in that we actually anticipate this amount to increase over time, especially as the amount of value-based reimbursement from payers continues to rise.

Ericka Dickinson [23:25]: Absolutely, that’s a great point. Thank you, Angie. So currently, our surveys report that, across the board at median rates, quality is about 5% of total compensation. That can be a little bit lower for your hospital-based specialties, your surgical specialties and your medical specialties, and can be at least currently, a little bit higher, up to about 6.3% of total comp for primary care specialties. Again, at the median for total compensation and Angie. Feel free to kind of add to my list, but I jotted down some kind of general quality metrics that I feel like I see pretty often. I see a lot related to HCAHPS scores, to readmission numbers, to hospital acquired infections, response times, and then on-time surgical starts for your surgical specialties, and I know some of those are a little more generic, and it’s pretty tempting to adopt some kind of generic system-wide goals. It’s definitely a lot less administratively burdensome. But we do encourage tailoring your quality measures, being specific and making them specialty specific whenever possible, or possibly grouping your hospital-based specialties, your primary care specialties, as you see on the screen here. Transparency is key. Providers

Angie Caldwell [24:48]: Sorry, Ericka, I was just going to say I completely agree. And as an example, if we’re thinking about if an organization’s strategy is to move the physician practice forward from an access perspective. So, for example, they want to create an environment where the patient has more access to the physician, then a quality and engagement incentive could be designed and aligned around that strategy. So as organizations become more strategically focused on making this compensation plan work for them. Designing these metrics can be fun, as long as they align with the organization and what it wants to achieve.

25:36 – Transparency and predictability in compensation plans

Ericka Dickinson [25:36]: Absolutely and transparency really becomes key, which leads us beautifully into our next slide. I actually had a kickoff call with a client just last week for some comp redesign, and we were wading through some of the more basic foundational questions, you know, like what providers are going to be looking for and what their current pain points are. And one of the administrators spoke up and said, you know, our physicians just want to know what they’re going to be paid every month. And everybody got kind of quiet. And it really struck us, because it’s such a simple concept, I think that any of us would want that we want to know what our cash flow looks like and how we can budget it, but yet, we create these physician compensation plans that are so nuanced and so complex, they kind of pile on top of each other, and administration turns over and nobody knows how it was set in the first place. It really becomes murky, and it becomes nearly impossible for providers to calculate their own compensation and have any sort of predictability around their paychecks, which is understandably a dissatisfier. So what becomes really key is clarity and communication, and those are really the foundational principles that help build trust between your leadership and your provider groups. And you can use predictable payment schedules to make a difference here as well. So biweekly or monthly draws, kind of creating a regular rhythm that give providers some stability and again, some predictability. And then for those incentives that we’ve talked about, again, important to clearly define what those metrics are, but equally important to set defined parameters for how and when those incentives will be reconciled and when they’ll be paid out. And so the more transparency you’re able to provide about how compensation was calculated, the better. And it’s also important to understand that reconciliation period. If you have a quality metric, for example, that you have to collect data on and wait for the results on that we need to be sure we’re considering how that timing can affect payouts, which then impacts provider perception and financial planning. So as an example, if a physician is waiting for two or three months for reconciliation of performance from their prior quarter, that can be frustrating, even if the payment is ultimately correct, it’s frustrating to have to wait on that delay and so again, consistency and communication are really crucial. This can create a little bit more of an administrative burden on the front end, if you’re creating dashboards or something like that, and I don’t want to minimize that effort, it is a little bit more cumbersome on the front end, but it does end up saving some time on the back end, and saving individuals from answering tons of questions about how pay was calculated, or possibly having to do true-ups or clawbacks down the road. And more visibility and more clarity can reduce frustration and dissatisfaction, which ties us back to the retention piece that we were talking about a couple slides ago. It can also be used as a recruitment tool. So if a candidate is shopping around in your market and another group in town has a really muddy, poorly written compensation plan, it can absolutely work in your favor to have a compensation model that is well structured and well defined, and then, whenever possible, try to standardize your models, both within departments and across departments, to ensure fairness equity and to ease some of the burden on your finance department and some of your other administrators,

29:23 – Competitive market intelligence and provider communication

Angie Caldwell [29:23]: Ericka, just to add another fine point to that, I think there is a good tactic here strategically. You mentioned the differences between compensation structures between you and your competitors in the market. I think it’s important as an organization gathers intelligence about what their competitors are offering in the market and catalogs it in a library, and tries to understand that compensation model as best as you can. Because from a retention and recruitment perspective, the strategy should be to make sure that when you are presenting that information and sharing that information with a recruit or with a current physician transparently, that they are able to compare and contrast, and if they’re not able to compare and contrast, then they understand why they’re not able to compare and contrast, and again, that communication and transparency then becomes that important tactic from a compensation plan strategy perspective.

30:40 – Operationalizing alignment: benchmark, engage, build flexibility, and refine

Ericka Dickinson [30:40]: So we’ve touched on the what. So let’s transition to the how. So the first step to operationalize is to benchmark. So you want to get a clear understanding of your market, both nationally and regionally, and depending on where you’re located, even state specific or city specific data may be helpful to understand, particularly if you’re in a state, a more populated state like New York or California, or a more rural state like Mississippi or Arkansas, that state and city specific data can be really beneficial. And this shouldn’t be your end-all, be-all, but it should be some good direction and give you some steady guardrails to get started, it can also be an indication of fair market value, and I am emphasizing bolding underlying indication of fair market value here again, not an end-all, be-all. But we want to make sure that while we’re getting creative with these compensation plans, that we are building something that will be compliant, and that will be fair market value, and it will be commercially reasonable. And so the benchmarks can help give us a starting point for that. And to Angie’s point, we’ll want to consider what your organization’s differentiator is, what makes you different from the hospital down the road or the practice you know one town over, and how do you account for those differences in your compensation design? Next is to engage your providers. So sit down with them, listen to them, really hear them, and try to come up with some collaborative models that really work for both sides. The more buy-in that you have from providers and trust that you’ve built between the group and between administration, the easier implementation can be, particularly if you’ve got some good provider champions who can really help drive that change internally within your organization. And if you’ve got some, you know, more critical providers, they can help to give a different, more positive perspective. And you know, we don’t want to be naive. These come with challenges, but the better foundation that you have, the smoother that they’ll go. And you can kind of build this physician engagement in a few different ways as you approach your compensation design. I’ve seen it work where folks have identified or nominated an individual and that person comes to the table on behalf of the group, and it is the group’s representative. I’ve also seen it as a governing committee, and so a group of people from, you know, clinical, from administrative, from finance, who come together and review and approve different options together, and next is to build in flexibility. And you might be thinking, hey, on the last slide, we were talking about standardization and streamlining, and now we’re talking about flexibility. How do these things go together? And yes, we want to standardize, we want to streamline, but we also need to be realistic. And so that means, again, we can’t take a one-size-fits-all approach to your compensation models. We’ve got to account for some differences in specialty, some differences for specific physicians as well. Thinking about those who are in leadership roles or teaching roles, they likely should be compensated differently, since their work effort looks a little bit different than others. And lastly, we want to continuously measure and refine. So compensation design is, you know, definitely more of an art than a science, and so it’s okay not to get it perfect 100% the first time, as long as you remain fluid and are open to making adjustments. I do think there’s a sweet spot, you know, kind of between letting a model work and kind of run its course and kind of debug itself along the way, but also kind of having that touch and knowing when it’s necessary to pivot. And so we’ve got to take feedback and adjust as needed just like how your organization is continuously reevaluating goals and strategies to achieve those goals, we need to be regularly reviewing compensation plans to ensure that they make sense and that they’re driving the results we want

34:47 – National, regional, and local compensation data

Angie Caldwell [34:47]: Ericka, before you leave that slide, one of the questions that we get very often is, what level of emphasis should we place on local market data and perhaps regional benchmark data as compared to national data. And I think the answer to that is, it depends, so really, to the extent possible, all three should be examined in determining a compensation plan or an offer to a recruit, and in determining fair market value compensation. So the more specific you get as to market, the more difficult that data is to obtain. It’s not like you can knock on your neighbor’s door, ask the question, and expect them to be willing to give you that information. But I do think it’s important to understand that the recruiting environment is a national one, and so organizations are recruiting nationally for this low supply of providers that we have across the country, number one and number two. If you’re recruiting nationally, and you agree that this is the market, then the other data becomes supportive and more defining around that offer, meaning the local market dynamics then adjust the national market information and help determine the competitiveness of that offer for the provider. Great.

36:22 – Key takeaways and Q&A

Ericka Dickinson [36:22]: So in summary, I’ve got sort of three key takeaways for you today, and so first, to understand that compensation can shape behavior, align priorities and drive organizational performance, but only when done intentionally and strategically. It comes from having a deep understanding of who you are as an organization and what you value most, and so intentional compensation design can drive your culture. It can reinforce quality, collaboration, accountability, and don’t get me wrong, productivity and revenue will always matter, but you can drive these other pieces and keep your providers engaged in the process and the productivity and the revenue will come as we’re seeing so many shifts in our industry. This is the time to really solidify the things that your organization prioritizes and design a creative and clear compensation model around that. It’s more than just the numbers, it’s truly a thoughtful approach to how to strengthen your provider group and your organization. So that brings us to the end. I’ve got some summary slides for us, but we wanted to take some questions from our Q&A and Angie while I’m kind of flipping through those and picking out a few for us to talk through. You mentioned something earlier, and I would love to get your thoughts on it. And specifically you said we hoped we had time to talk about TEAM, not meaning our APP and physician complement or team care models, but thinking about CMS alternative payment model and the acronym for TEAM being the Transforming Episode Accountability Model. Angie, can you talk a little bit about how you see this impacting compensation in the future?

38:09 – TEAM and value-based compensation alignment

Angie Caldwell [38:09]: Yes, thank you. I really wanted to emphasize that TEAM is a great opportunity to strategically align your compensation model simply because of its nature. So not all of our attendees today are going to be a mandatory participant in TEAM, but to the extent that they are, or if they are medical staff members of a hospital that is a TEAM participant, it could potentially be an opportunity, as it relates to collaborator agreements that are an opportunity under the bundled payment model. And so what that means is, again, TEAM is an opportunity. It is a value-based compensation model. It is related to certain surgical episodes. It is tied to traditional Medicare, red, white, and blue Medicare, not managed Medicare. So there is an opportunity. If you think about what your organization needs to accomplish under TEAM, which is to create savings under the episode, then, to the extent that there are savings, how can then you drive that savings through a compensation strategy. So there’s a real opportunity for organizations to think through that and work with their physician partners under collaborator agreements to really help drive that change and drive that value within the TEAM model. So please understand, if anyone in the audience wants to know more about TEAM, we have information on our website and a roadmap and lots of great information out there. In the first year, many organizations are viewing the first year of TEAM to be kind of no risk. It’s upside only. My only caution is that while you’re waiting for that first year of measurement to come in and the upside only, couldn’t you be preparing for the second year, when it is upside and major downside for your organization to really position yourself to not leave anything on the table going forward. So it is a real opportunity, from a strategic perspective to align compensation with providers.

40:24 – CY 2026 MPFS proposed rule and wRVU considerations

Ericka Dickinson [40:24]: Awesome. Thank you, Angie, really insightful. I’m seeing one question asked a few times, and it’s about the 2026 proposed rule for the physician fee schedule. So I’ll make a couple comments here, but particularly when we’re thinking about the proposed rule. And again, this hasn’t been passed, and it just came out last week, and it’s pretty dense, so I think people are still kind of making their way through it. But a big piece that I’ve seen talked about a lot so far is this efficiency adjustment for non-time-based services, and so wRVUs are anticipated to decrease by about 2.5% and then they’re expecting a downward adjustment every three years. And currently there is no stated cap on that downward adjustment, so we anticipate seeing wRVUs trending downward over the next few years. And I think that’s interesting for a few reasons, but particularly when we talked earlier. You know, I mentioned that wRVU models are really becoming outdated, and I think we are really seeing that catch up. And so I think we will see a lot of hospitals, health systems, physician groups, move away from wRVU-based models in the next few years, not only for the reimbursement aspect, but now that’s definitely a contributing factor to moving that way. And so I think we’ll see this a lot in our specialties with high volume and short visit durations. So thinking dermatology, ophthalmology, urology and radiology, which is interesting, and feel like radiology is really a hot topic right now. We’re seeing a lot of it, a lot of groups asking hospitals for subsidies that we haven’t seen in the past. And also, radiology isn’t a specialty that’s anticipated to be impacted a lot by artificial intelligence and AI, and that’s really hot in our industry right now, too. Angie, I know you’ve done a lot in the AI space when it comes to healthcare. Can you talk a little bit about how you see AI impacting provider productivity and compensation?

42:38 – Artificial intelligence, productivity, and provider compensation

Angie Caldwell [42:38]: Absolutely, as wRVUs continue to shift. So you know, everybody with us today, we all love to hate a wRVU, and we understand that it’s a great consistent measure. It’s published, it’s reliable. But I think as time goes on, and as you already know, from a measurement perspective, questions are arising about whether that time value is really there, and is the wRVU really the right measure to capture the physician’s effort? And then when we overlay AI on top of that, I think we’re going to have more questions. So, you know, AI is not going to replace necessarily, the you know, the physician’s touch in a surgery, the physician’s touch in making some of the most critical decisions as to life or death. However, AI will play a role in medicine, just as it’s going to play a role in all of our lives, so to the extent when we’re thinking about a productivity-based wRVU model, to the extent that AI is increasing the efficiency, reducing the time, we can’t help but to then logically reason that AI will also impact the wRVU measurement itself, perhaps reducing it. What will that do within the RVU and the total package? Does more move into practice expense instead of physician work effort to account for the cost of AI within a physician practice? Time will tell. But it is an interesting thing to begin thinking about now, because, as we know, AI has been so rapidly accepted, and it’s rapidly changing the way all of us live and work.

Ericka Dickinson [44:33]: Awesome. Thank you, Angie. I really appreciate it. I’m going to toss it back over to Jennifer to wrap us up for today.

44:42 – Closing remarks

PYA Moderator [44:42]: Thanks to our presenters, Angie and Ericka, please remember to stay on the line once the webinar disconnects to complete a short survey. Later today, you’ll receive an email with their contact information and a recording of the webinar, also the slides and recordings for all of PYA webinars are available on the thought leadership section of PYA’s website, pyapc.com, while at our website, you may register for other PYA webinars and learn more about the full range of services offered by PYA. Please remember to stay on the line once the webinar disconnects, to complete the short survey and post any additional questions you may have on behalf of PYA. Thank you for joining us. Have a great rest of your day.