Download In Year 2

To Heal. To Teach. To Discover.
UHMG Compensation Plan
Year 2 Updates – January 2016
Dec 9, 2015
Be the Difference.
Update # 1: Methodological Change for Clinical Base Calc
In Year 1: Faculty received 1/3rd of the Clinical Base Variance
In Year 2: Faculty receive ½ of the Clinical Base Variance
• Year
1 Calculation Example:
• Year
2 Calculation Example:
•Current Clinical Comp =
$101k
•Current Clinical Comp =
$134k
•Calculated Clinical Comp =
$200k
•Calculated Clinical Comp =
$200k
•Variance =
$ 99k
•Variance =
$ 66k
•Divided by 3 =
$ 33k
•Divided by 2 =
$ 33k
•Current Clinical + 1/3 Variance = $134k
•Current Clinical + 1/2 Variance = $167k
2
Be the Difference.
Update # 2: Methodological Change for Productivity Tier
Faculty > 75th in Both Prod & Comp: Will Not Keep Current Comp
Faculty > 75th in Prod but < 75th in Comp: Continue to Climb to the 75th
• In Year 1: Faculty producing above the 75th %ile were split into two groups with the following effect on comp:
•If Currently Paid Above the 75th: No increase or decrease to current clinical compensation
•If Currently Paid Below the 75th: Current clinical compensation raised to the 75th (1/3rd adjustment in 1st Yr)
• In Year 2: Faculty producing above the 75th %ile are split into two groups with the following effect on comp:
•If Currently Paid Above the 75th: Comp adjusted Bi-Directionally to ½ of the variance of RVU %ile – Comp %ile
(see both examples below)
•If Currently Paid Below the 75th: Current clinical compensation raised to the 75th (1/2 adjustment in 2nd Yr)
• Positive Adjustment to Clinical Base:
•wRVU %Ile = 90th & Comp %ile = 80th
•Clinical Base will be set at the 85th – ((90th – 80th) / 2) + 80th = 85th
• Negative Adjustment to Clinical Base:
•wRVU %Ile = 84th & Comp %ile = 92nd
•Clinical Base will be set at the 88th – ((84th – 92nd) / 2) + 92nd = 88th
•Maximum %ile can be set at is 99th %ile
3
Be the Difference.
Update # 3: Benchmarking Change
In Year 1 UHMG Used the 2014 Survey Only (MGMA, AAAP, AAARAD)
Going Forward UHMG Will Utilize the 5 Most Recently Published
Surveys (from MGMA, AAAP, & AARAD)
•
The UH Comp Plan benchmarks will be calculated annually and based entirely off the most
recent 5 Published Surveys for both Comp & Prod
•
This captures the trend taking place in the market while also smoothing out large year to
year swings often found in benchmarking data
•
Methodology: Fluctuate the 2014 Benchmarks (Used in Year 1) by the Average of the Annual % Change
over a 5 Year Period (Survey Yrs 2011-2015)
•
See following 3 slides for examples around productivity benchmark calculations for several surgical divisions
4
Be the Difference.
Update # 3: Benchmarking Change (cont’d)
Example 1:
2011 – 2015 Surgical Division wRVU Benchmarks:
2012 MGMA ACADEMIC
Specialty
Surgery: Colon & Rectal
Surgery: General
Surgery: Neurological
Surgery: Oncology
Surgery: Plastics
Surgery: Thoracic
Surgery: Transplant
Surgery: Trauma
Surgery: Vascular
n
29
105
112
87
52
55
59
74
70
25th
%tile
Median
5,844
7,886
6,333
7,911
6,539 11,251
5,755
7,429
5,861
8,582
5,358
6,857
5,505
8,488
6,989
9,295
6,577
9,775
75th
%tile
10,660
11,251
15,218
9,958
11,735
10,790
11,128
13,502
12,524
2011 MGMA ACADEMIC
90th
%tile
11,468
14,157
17,437
13,142
13,871
16,650
13,456
16,871
15,316
n
18
118
100
64
52
34
42
65
53
2015 MGMA ACADEMIC
Specialty
n
Surgery: Colon & Rectal 32
Surgery: General
107
Surgery: Neurological
150
Surgery: Oncology
80
Surgery: Plastics
81
Surgery: Thoracic
65
Surgery: Transplant
36
Surgery: Trauma
83
Surgery: Vascular
50
25th
%tile
Median
7,149
8,465
6,516
9,019
6,957
10,772
5,561
7,938
7,062
10,706
6,406
8,795
6,203
8,655
5,665
8,479
7,635
10,484
75th
%tile
11,074
11,518
15,654
9,818
14,248
11,336
11,582
11,951
14,335
25th
%tile
Median
6,615
8,011
5,930
8,098
6,805
10,785
4,783
7,571
6,813
8,661
4,686
7,205
6,156
8,733
7,276
10,429
6,785
10,416
75th
%tile
10,874
10,600
15,788
9,613
11,119
11,140
10,186
13,230
13,283
90th
%tile
16,123
13,961
20,242
12,273
14,332
15,701
13,985
17,562
16,985
2014 MGMA ACADEMIC
90th
%tile
13,137
13,976
21,147
14,749
17,533
17,270
14,914
14,918
17,150
n
32
142
104
92
105
65
96
103
82
25th
%tile
Median
5,722
8,848
5,282
7,525
6,603
9,977
5,972
9,012
5,628
8,775
5,387
8,156
6,265
8,258
6,187
8,996
7,662
9,980
75th
%tile
12,866
10,130
14,289
11,592
12,400
12,679
11,069
10,643
12,389
2013 MGMA ACADEMIC
90th
%tile
13,936
13,135
19,019
15,364
16,760
14,665
13,980
13,488
16,446
n
29
133
122
73
73
70
75
95
66
25th
%tile
Median
6,163
9,453
5,238
7,571
5,962
9,085
5,810
7,778
5,531
7,926
6,042
8,631
5,174
7,048
5,964
7,991
6,823
9,389
75th
%tile
12,269
9,536
13,472
10,116
11,512
13,081
9,497
10,336
13,171
90th
%tile
13,504
12,353
18,931
13,430
15,600
19,837
11,602
13,051
16,383
5
Be the Difference.
Update # 3: Benchmarking Change (cont’d)
Example 1 (cont’d) :
Surgical Division 5 Yr Annual % Change & Yr 2 Calculated wRVU Benchmarks:
25th %ile Annual % Change
2011
2012
2013
thru
thru
thru
Specialty
2012
2013
2014
Surgery: Colon & Rectal -11.6% 5.5%
-7.2%
Surgery: General
6.8% -17.3% 0.8%
Surgery: Neurological
-3.9% -8.8% 10.7%
Surgery: Oncology
20.3% 0.9%
2.8%
Surgery: Plastics
-14.0% -5.6%
1.8%
Surgery: Thoracic
14.3% 12.8% -10.8%
Surgery: Transplant
-10.6% -6.0% 21.1%
Surgery: Trauma
-4.0% -14.7% 3.7%
Surgery: Vascular
-3.1%
3.7% 12.3%
2014
2014
thru
Avg % MGMA
2015 Change (Yr 1)
24.9%
2.9%
5,722
23.4%
3.4%
5,282
5.4%
0.8%
6,603
-6.9%
4.3%
5,972
25.5%
1.9%
5,628
18.9%
8.8%
5,387
-1.0%
0.9%
6,265
-8.4%
-5.8%
6,187
-0.4%
3.2%
7,662
75th %ile Annual % Change
2011
thru
Specialty
2012
Surgery: Colon & Rectal -2.0%
Surgery: General
6.1%
Surgery: Neurological
-3.6%
Surgery: Oncology
3.6%
Surgery: Plastics
5.5%
Surgery: Thoracic
-3.1%
Surgery: Transplant
9.2%
Surgery: Trauma
2.1%
Surgery: Vascular
-5.7%
Yr 1 & 2 Benchmark
2014 +
Avg %
Change
(Yr 2)
5,888
5,463
6,659
6,228
5,735
5,861
6,320
5,826
7,904
Yr 1 & 2 Benchmark
2012
2013
2014
2014
thru
thru
thru
Avg % MGMA
2013
2014
2015 Change (Yr 1)
15.1% 4.9% -13.9% 1.0%
12,866
-15.2% 6.2% 13.7%
2.7%
10,130
-11.5% 6.1%
9.6%
0.1%
14,289
1.6% 14.6% -15.3% 1.1%
11,592
-1.9% 7.7% 14.9%
6.6%
12,400
21.2% -3.1% -10.6% 1.1%
12,679
-14.7% 16.6% 4.6%
3.9%
11,069
-23.4% 3.0% 12.3% -1.5%
10,643
5.2% -5.9% 15.7%
2.3%
12,389
2014 +
Avg %
Change
(Yr 2)
12,997
10,404
14,308
11,721
13,214
12,819
11,506
10,480
12,675
Median Annual % Change
2011
2012
thru
thru
2012
2013
-1.6% 19.9%
-2.3% -4.3%
4.3% -19.2%
-1.9%
4.7%
-0.9% -7.6%
-4.8% 25.9%
-2.8% -17.0%
-10.9% -14.0%
-6.2% -4.0%
2013
thru
2014
-6.4%
-0.6%
9.8%
15.9%
10.7%
-5.5%
17.2%
12.6%
6.3%
2014
2014 2014 + Avg
thru
Avg % MGMA % Change
2015 Change (Yr 1)
(Yr 2)
-4.3%
1.9%
8,848
9,016
19.9%
3.2%
7,525
7,763
8.0%
0.7%
9,977
10,048
-11.9% 1.7%
9,012
9,165
22.0%
6.0%
8,775
9,305
7.8%
5.8%
8,156
8,633
4.8%
0.5%
8,258
8,303
-5.7%
-4.5%
8,996
8,589
5.1%
0.3%
9,980
10,011
90th %ile Annual % Change
2011
thru
2012
-28.9%
1.4%
-13.9%
7.1%
-3.2%
6.0%
-3.8%
-3.9%
-9.8%
2012
2013
thru
thru
2013
2014
17.8% 3.2%
-12.7% 6.3%
8.6%
0.5%
2.2% 14.4%
12.5% 7.4%
19.1% -26.1%
-13.8% 20.5%
-22.6% 3.3%
7.0%
0.4%
Yr 1 & 2 Benchmark
Yr 1 & 2 Benchmark
2014
2014 2014 + Avg
thru
Avg % MGMA % Change
2015 Change (Yr 1)
(Yr 2)
-5.7%
-3.4%
13,936
13,460
6.4%
0.3%
13,135
13,181
11.2%
1.6%
19,019
19,322
-4.0%
4.9%
15,364
16,119
4.6%
5.3%
16,760
17,652
17.8%
4.2%
14,665
15,284
6.7%
2.4%
13,980
14,316
10.6% -3.2%
13,488
13,062
4.3%
0.5%
16,446
16,520
6
Be the Difference.
Update # 3: Benchmarking Change (cont’d)
Example 1 (cont’d) :
Surgical Division Year 1 & Year 2 UH Comp Plan wRVU Benchmarks:
Year 1 vs Yr 2 Benchmark Summary
Year 1:
25th
Specialty
%tile
Surgery: Colon & Rectal
5,722
Surgery: General
5,282
Surgery: Neurological
6,603
Surgery: Oncology
5,972
Surgery: Plastics
5,628
Surgery: Thoracic
5,387
Surgery: Transplant
6,265
Surgery: Trauma
6,187
Surgery: Vascular
7,662
Year 2:
25th
%tile
5,888
5,463
6,659
6,228
5,735
5,861
6,320
5,826
7,904
Delta:
25th
%tile
2.9%
3.4%
0.8%
4.3%
1.9%
8.8%
0.9%
-5.8%
3.2%
Year 1:
50th
%tile
8,848
7,525
9,977
9,012
8,775
8,156
8,258
8,996
9,980
Year 2:
50th
%tile
9,016
7,763
10,048
9,165
9,305
8,633
8,303
8,589
10,011
Delta:
50th
%tile
1.9%
3.2%
0.7%
1.7%
6.0%
5.8%
0.5%
-4.5%
0.3%
Year 1:
75th
%tile
12,866
10,130
14,289
11,592
12,400
12,679
11,069
10,643
12,389
Year 2:
75th
%tile
12,997
10,404
14,308
11,721
13,214
12,819
11,506
10,480
12,675
Delta:
75th
%tile
1.0%
2.7%
0.1%
1.1%
6.6%
1.1%
3.9%
-1.5%
2.3%
Year 1:
90th
%tile
13,936
13,135
19,019
15,364
16,760
14,665
13,980
13,488
16,446
Year 2:
90th
%tile
13,460
13,181
19,322
16,119
17,652
15,284
14,316
13,062
16,520
Delta:
90th
%tile
-3.4%
0.3%
1.6%
4.9%
5.3%
4.2%
2.4%
-3.2%
0.5%
7
Be the Difference.
Update # 4: 2016 Incentive Template Draft
CMS MIPS – Merit Based Incentive Payment System:
Final Weights and Metrics TBD
UHMG "PCP" 2016 Incentive Structure
M
M
en
u
et of
ri c
Ca s B
te y
go
ry
Weight
Quality
Resource Use
Measures
Clinical
Improvement
Productivity
Chair's Discretion
30%
30%
15%
15%
10%
Metric # 1
Metric # 1
Metric # 1
Metric # 1
Metric # 1
Metric # 2
Metric # 2
Metric # 2
Metric # 2
Metric # 3
Metric # 3
Metric # 3
Metric # 3
Anesthesia Pain Mgmt
Dermatology
Emergency Medicine
Family Medicine
Genetics
Orthopedics
OBGYN
Medicine
Pediatrics
8