A wise person once told me there are only 2 levers in business. You can do one of two things to succeed profitably. You can increase your revenue or decrease your expenses. It’s really that simple. To improve profitability you must either increase your revenue or decrease your expenses. I’ve personally been part of organizations that were growing as well as those that were not growing, even shrinking in revenue. Let’s start with growth though.
Topics: physician contracts
Health care organizations pay physicians for a variety of duties that are not patient care based, but are more administrative or perhaps task based activities that are for the benefit of the company, not necessarily the physician. These activities are not defined as productive time, meaning the physician cannot bill insurance companies or a patient for this time. It is work being performed on behalf of another organization, not a patient. Over time, health care organizations such as hospitals, device companies, large physician groups, pharmaceutical companies have had to pay physicians a fair hourly rate for all the hours asked of physicians.
Topics: physician contracts
The regulatory environment dictates that hospitals who contract with physicians meet specific conditions in order for the contract to be legal. The conditions are meant to ensure the physician payment is not based on volume or value of business because it can lead to overusing services and increasing overall costs of care. Technically violating your own contracts can lead to multi-million dollar settlements.
Our hospital clients have let us know that the handling of physician administrative contracts is a “hot potato” within their administrative team. Nobody seems to want to fully own the issues that come along with these complicated contracts; everyone seems to own a piece of physician administrative contracts such as compliance, medical staff offices, hospital administration, legal teams and the finance department.
At Ludi, our sole focus is physician administrative contracts. These are the legal vehicles that contain a variety of administrative services that physicians provide to hospitals that are not clinical. These services include medical directorships, on-call, co-management agreements, and physician committee work to name a few. We work with various sizes of health systems and have noticed several patterns, regardless of size, that all hospital administrative teams fall into when automating their manual processes that currently support their payment processes and executive of their physician contracts.
Hospitals and their many contracts have long been determined as a problem to manage. Several organizations have created top-of-the-line software for hospitals to eliminate paper, wasted time, and automated preparation for those looming threats of an audit.
Hospitals need physician partnerships in nonclinical settings and activities. Many hospitals often choose physician arrangements known as “medical directorships." These arrangements designate a physician leader to be responsible for a number of activities related to the delivery of medical care and clinical services. The "activities" typically include things like cost management, utilization review, quality assurance, and medical protocol development. Medical directorships are a popular partnership vehicle to assist the hospital in necessary clinical administrative leadership. They also align their physicians as partners for smart and intuitive direction. Read on to learn what should (and shouldn't) exist in an optimal medical directorship contract.
Physician administrative agreements are complex largely because of the challenging compliance regulations they must follow. Based on the thousands of agreements we’ve read on behalf of our clients, there is a cycle taking place where the agreements are getting more complicated as the compliance landscape becomes more rigid. This can create a series of problems when it comes to writing and managing these agreements over time. Take a read through the physician contracting errors that we’ve seen throughout agreements that can cause both short and long-term problems.
Physician contracts should, in theory, be created using templates as a best practice. The reality is that physician contracts are like snowflakes: it’s difficult to find two that are alike. In practice, having too much variation in your physician contracts can be detrimental to the organization. High level of variation can lead to operational problems while trying to execute agreements.
Ludi has had the pleasure of reading close to 7,500 physician contracts in the last three years. From this experience comes a tip sheet on how to construct the optimal physician contract.