Insights from SullivanCotter’s Physician Compensation and Productivity Survey
The pressure on financial sustainability continues to increase for community health systems. Lower professional collections per wRVU and higher total cash compensation (TCC) per wRVU when compared to the national average increases the financial support community health systems must provide to maintain their employed medical staff.
Turn insight into action with the right data!
Compensation
When compared to national averages, physician TCC per wRVU is higher in community health systems across all specialty categories. However, collections per wRVU for physician services are lower than national averages, indicating that physicians within community health systems are paid more for each wRVU they generate and for each professional services dollar collected than national averages.
Median Annual TCC per wRVU and Collections per wRVU
(Percent Difference Compared to National Averages)
- Primary Care: TCC per wRVU: 7.1% – Collections per wRVU: -9.9%
- Medical: TCC per wRVU: 2.3% – Collections per wRVU: -6.1%
- Surgical: TCC per wRVU: 3.0% – Collections per wRVU: -6.3%
- Hospital-Based: TCC per wRVU: 6.1% – Collections per wRVU: 2.3%
- Aggregate: TCC per wRVU: 3.6% – Collections per wRVU: -6.3%
Clinical Work Hours and Call Coverage
Hospital-based specialties in community health systems are required to work more annual hours than national averages, but are also more likely to be paid for their call coverage hours.
Median Annual Clinical Work Hours Required for 1.0 FTE in Hospital-Based Specialties
(Percent of National Average)
- Emergency Medicine: 106.7%
- Pediatrics – Hospitalist: 106.5%
- Critical Care Medicine: 104.3%
- Hospitalist: 104.3%
- Urgent Care: 102.0%
- Neurology – Neurocritical Care: 101.6%
Call Pay Prevalences for Full-Time Clinical Staff Physicians
(Percent Paying)
- Hospital-Based: Community Health Systems: 14.6% – National: 7.9%
- Medical: Community Health Systems: 14.0% – National: 8.4%
- Primary Care: Community Health Systems: 9.4% – National: 5.4%
- Surgical: Community Health Systems: 27.5% – National: 17.1%
Student Loans
Community health systems offer student loan repayments more frequently than the national average, suggesting more difficulty in recruitment.
Student Loan Repayment Used for Staff Physicians
Community Health Systems
- Offer for all new hires: 24.0%
- Offer for select specialists: 8.0%
- Offer as needed: 34.0%
- Do not offer: 34.0%
National
- Offer for all new hires: 11.7%
- Offer for select specialists: 9.2%
- Offer as needed: 31.3%
- Do not offer: 47.9%
How can community health systems address these challenges?
Carefully Balanced Compensation Design and Recruitment
- Implement core performance expectations – including a minimum level of service tied to base salary as a requirement before any potential incentive is paid
- Align productivity incentive eligibility with financial affordability with a specific focus on the retention of high performers
- Include non-productivity incentives, such as physician and APP care coordination, that are aligned with payer performance incentive dollars
- Ensure advanced practice provider (APP) compensation program is externally competitive and aligned closely with the physician plan
Thoughtful Workforce Planning
- Update provider needs assessments for physicians and APPs regularly to anticipate recruitment needs and allow plenty of time to recruit
- Focus on recruitment and retention within the local community – including incumbents and training programs with geographic ties to candidates
- Considering the high cost to replace providers and staff, ensure that succession planning is proactive and coordinated
Performance Enhancement
- Use collaborative care models to ensure top-of-license practice for all providers and care team members
- Reward team-based care with shared incentives
- Improve patient access via joint panels, maximizing APP scheduling, and more Implement compensation management software to reduce administrative burden and build trust between administration and providers
