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Hint: Think Beyond the Signing Bonus

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Are you concerned about losing a new physician in the first few years of hire? Wary of spending a lot to recruit a candidate physician – signing bonuses, relocation, search fees – only to see him or her leave? Here are a few ideas to keep good physicians on board.

Right now, most financial packages are weighted toward getting the physician signed. A typical signing bonus is $15K-$20K, depending on specialty, often with a loan repayment component, as well. What does that do for the candidate physician or you in the long run in terms of long-term stability?

Unlike a one-time signing bonus, retention incentives offer bonuses after specific periods. To be competitive, you’ll still need some kind of signing bonus. But if the goal is to keep the candidate physician, why not weight the compensation toward retention instead?

For example, if the physician you’re negotiating with wants a signing bonus of $10,000, try offering $10,000 up front or $5,000 now and $10,000 more after a year (or as much as you can offer down the road). Arrange the package to pay out more over time, but only if the physician is still there and has built a solid practice and billings.

Examples of Retention Packages

• A hospital in Colorado offers a signing bonus of $7,500 and a small bonus after year one and two, with $20,000 after year three, $10,000 after four and $10,000 after five.
• A national health system developed its own standards of practice and gives $1,000/month for meeting standards, providing an extra $12,000 per year.
• A nationwide clinic system offers $10,000 at signing with a $7,500 performance bonus yearly.

Whatever your compensation formula is, be sure you keep it easy to understand. And the longer you can take the retention bonus out, the better. After three years, we’ve seen the chances of a candidate staying long term go up significantly (because he or she will have built a practice and gotten comfortable in the community).

Making commitments that far into the future can be challenging in these unpredictable times of healthcare changes, but approaching physician recruitment with confidence will go a long way toward ensuring you have the talent you need to succeed.

The MGMA’s In Practice blog recently offered some helpful insights on developing winning physician compensation packages, based on the organization’s 2012 starting salary survey. Concorde expands on the list with these 10 considerations to give your candidates offers they can’t refuse.

With 29 years of experience in the industry, we have seen all kinds of variations in employment offers. Our current market observations suggest the following things to keep in mind:

1. Beyond the contract – Physicians are looking for incentive provisions and some idea of what their compensation will be like after the initial contract is over.
2. Job security – Primary care physicians and some Internal Medicine sub-specialists often prefer hospital employment vs. private practice.
3. Help with educational costs – Financial assistance – such as loan repayment or a stipend for the last year of training – is in high demand.
4. Outpatient positions – These positions are growing popular among primary care physicians.
5. Signing bonuses – $20,000-$50,000 is very common – best to offer with a time constraint (e.g., if you sign in 3 weeks).
6. Vacation – 4 weeks is standard for primary care physicians.
7. Family Medicine rising – Compensation for these specialists is approaching $200,000+.
8. Hospitalist schedules – Looking for a 7 days on, 7 days off schedule.
9. Reasonable non-competes – Don’t overreach; you’ll turn off good candidates.
10. Deadlines – The best way to sign your physician – give them a solid deadline, and stick to it!

Before you sign the right candidates, of course, you have to find them. So give us a call at 800-334-6407, or contact a Concorde consultant online, and let us help you find the most promising physicians for your organization and help you get them signed.

Read the MGMA’s compensation package tips.

Meet “Dr. Sophia.” She’ll soon be starting her Family Medicine Residency. And as a friend of Concorde, you’ll be able to follow along via Twitter. Be sure to join us for this rare and valuable glimpse into the world of a next-generation recruit.

Dr. Sophia has kindly agreed to share insights about her residency experience, bringing you a better understanding of the expectations and challenges of the “new physician.”

She’ll address key issues such as:

• How has the Affordable Health Care Act affected her training?
• What challenges does she face when considering good patient care vs. the cost of care?
• What do physicians like her want most in a position?

Stay tuned for Dr. Sophia’s first posts in the coming months. In the meantime, do you have a specific question of your own you’d like her to answer? Send us queries for Dr. Sophia via email at info@concordestaffing.com or via Twitter (@ConcordeStaff).

Are you following Concorde on Twitter? It’s your convenient connection to all the latest trends, tips and developments in healthcare staffing. We’re determined to save you time while keeping you in the know.

Don’t overload your already busy day trying to spot the important stories in all those newspapers, magazines and journals. Our team is surveying the whole scene – so you don’t have to.

You can access it all in one feed, whenever you want, from your smartphone, tablet or PC. It’s the easiest, quickest way to stay on top of what matters in the field.

Here’s a sampling of recent nuggets from our feed:

• Bringing PAs and NPs on board: what to do when you’re hiring http://bit.ly/eio875
• 20 statistics on salary offered to top recruited physician specialties http://bit.ly/QMdBU1
• Medscape Physician Compensation Report: 2012 Results http://bit.ly/QFCKkl

And coming soon, get a front-row seat for a first-year physician’s experiences. Don’t miss out on these and other valuable insights. Connect with us now athttp://twitter.com/concordestaff.

A recent industry survey indicates that Locum Tenens medical professionals are here to stay.

Here are some Locum Tenens facts revealed in a recent survey by Staff Care:

• The percentage of medical facilities using locum tenens physicians hasn’t been lower than 75% since 2006.
• On an average day in 2011, more than 40% of all medical facilities were searching for locum tenens doctors.
• In 2011, most medical facilities used one or more locum tenens doctors every 31 days.
• Nearly 80% of administrators feel the value of locum tenens physicians outweighs the cost.
• Locum tenens doctors are most frequently used as back-ups while administrators search for more permanent staff.

Meanwhile, to help meet the demand, we’re happy to report that we’re seeing an increase in high-quality physicians looking for LT positions. So be sure to give us a call to learn about our latest candidates who can help you fill the gaps.

RVU Maximizing Your Reimbursement?

By Kathryne Plato, CPC
Director of Coding at ebix

Proper dictation and coding is a key to maximizing revenues both for your organization and your physicians – especially if you’re using a Relative Value Units (RVU) formula. That’s why the following tips on RVUs are a win-win; share them with your physicians.

First, a quick look at how RVUs are calculated. They’re dependent on the patient encounter being coded accurately and in a timely manner.

• Physician Work RVUs account for the time, technical skill, mental effort and judgment, and stress to provide a service.
• Practice Expense RVUs account for the non-physician clinical and non-clinical labor of the practice, as well as expenses for building space, equipment, and office supplies.
• Professional Liability Insurance RVUs account for the cost of malpractice insurance premiums.

Each of these components is adjusted geographically using separate Geographic Practice Cost Indices (GPCI). The final formula to calculate your area’s specific relative value:

(Practice Expense RV x Practice Expense GPCI) + (Work RV x Work GPCI) + (Malpractice RV x Malpractice GPCI)

5 RVU Tips for Physicians

1. Note that if level 3 and level 4 visits are done in the office, your RVUs may be similar to those of a physician who performs many level 1 and level 2 visits in the hospital.
2. Know your payer mix and review your contracts to determine your reimbursement. For example, if services you provide target a specific demographic (e.g. the elderly) then the largest payer will be Medicare/MCO (Managed Care Organization).
3. Keep up with industry changes to help improve productivity without interrupting the quality of care. For example, 5010 Electronic Billing and EDI Transactions compliance is required by Jan. 1, and the ICD-10 requirement begins Oct. 1, 2013.
4. Stay informed on specific payer guidelines to ensure prompt payment. A good start would be to review local and national coverage determinations (LCD/NCD).
5. Be certain your practice management system is in accordance with AMA guidelines to create customized reporting.

[panel style=”box”]ABOUT ebix
ebix inc., Greendale, WI, is a revenue cycle management firm offering independent Emergency Room physician groups coding expertise, denials minimization and data analytical services. For an average client, ebix inc. generates an additional 10% of revenue. ebix provides complete, consistent and timely medical coding and billing services, letting physicians focus on the excellence of their patient care, not back room operations. To learn more, please visit www.ebixinc.com[/panel]

In Concorde’s stringent qualification process, it’s often as much about the candidates we don’t send you, as those we do. So we thought you might like to know why some candidates might not make the cut. Here are the six most common reasons:

1. Gaps in employment or residency changes. These issues must be looked at closely, but with proper and verified explanations, they may be fine.
2. Certification delays. It could mean the candidate didn’t pass an exam or didn’t believe it was important, but sometimes there’s a more satisfactory explanation.
3. Departures for “political reasons.” Peculiar or vague explanations for leaving a position are often a front for more serious issues.
4. Unacceptable malpractice history. The number, frequency, nature and judgment amounts of lawsuits must be carefully examined.
5. Appearing on Medicare or Medicaid exclusion lists. Any history of billing problems or fraud investigations can cause real problems for any employer.
6. Questionable job search priorities. If their major interest is money, then they may not be a good fit.