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It’s interesting to me that this came from the administration down to the physicians to expand without having some planning for it. I have certainly seen it the other way, with physicians trying to add more and more. Sometimes this is due to an assumption that all endeavors are profitable. Other times, it seems that some of the drive for this is that physician compensation incentives are driven solely by “productivity” rather than “profitability” or the overall mission. From the health system point of view, not all RVUs are equal, but for the physician that has productivity based incentives, more RVUs = more compensation.
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Another thought to piggyback off of that, is that the situation continues to get more complex as the ‘hospital employed’ model grows. The physician’s value is more than just salary and wRVU production. There is the other added benefits to the facility that also provide value to the hospital. For procedural specialties, it is the facility fees, etc that probably add more to the hospital’s bottom line than physician professional fees. For non-procedural specialties, there is added value by ‘exclusive’ referral to the facilities such as radiology, consultants, etc.
Unfortunately, while I agree that it would be a better system to let people know their value to the system, I think in a lot of ways that is not the typical.
Interestingly, we had our group’s business meeting today. There were some numbers on the income statement for the group that did not make sense. When I asked the administrator about it, they couldn’t tell us where that number came from and why it looked far more unfavorable that it should have. Still awaiting the answer!
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At my organization, I can get, but have to ask for, the statements for my division. To my knowledge, they do not do individual statements for each physician. Additionally, this information is not available monthly. Most of the decision making is made by administrators, not the physicians, as far as I can tell.
As far as the statement for analysis goes, I think that the most obvious item to me was the high A/R. This has the appearance of significantly hurting the liquidity ratios, specifically the days in A/R.
Finally, as far as the procedures and RVU, I think that could be useful information. There are some types of practices that are subject to widely variable volumes based on external factors. For instance, I am part of a hospital employed acute care surgery group. Currently, we do not have an outpatient side to our practice (which I would love to build) so our volumes are all related to ED/inpatients. Being able to see how many procedures we performed and relating that to the financial side can give valuable insight. It also could be a red flag if the procedure numbers were high but revenues decreasing, might demonstrate a leak in the system that needs to be fixed!
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