COVID-19: Provider Compensation Considerations and Financial Viability

na altura da pandemia covid-19, o Centros para serviços do Medicare e Medicaid (cms), o= U.S. Cirurgião Geral e o American College of Surgeons (ACS) instou os hospitais a atrasar os procedimentos eletivos e as visitas de saúde não essenciais. Embora esses serviços estejam voltando lentamente à medida que a indústria muda para a fase de recuperação da crise, Procedimentos eletivos Faça uma parte substancial da receita de um hospital. A lacuna nesses serviços, por mais breve, apresenta muitos desafios financeiros, à medida que as organizações de saúde se esforçam para Gerenciar despesas, ao mesmo tempo em que fornecem os cuidados que suas comunidades precisam. Linhas de crédito, negociando com fornecedores e fornecedores,

There are various prudent financial actions organizations can take to maintain financial stability during difficult times, including carefully deferring costs, quickly moving to access available lines of credit, negotiating with vendors and suppliers, Acelerando o fluxo de caixa e alavancando os relacionamentos pagadores-provedor. As organizações devem ser exaustivas Todos os programas possíveis de concessão e empréstimo Amarrado ao dinheiro do estímulo federal e outros recursos. No entanto, os líderes devem considerar o ambiente único e as comunidades específicas de sua organização ao determinar se os cortes de compensação de provedores são prudentes. Além disso, é imperativo que a organização consulte seu departamento jurídico antes de fazer alterações. Abaixo estão as considerações sobre como reduzir a compensação no curto prazo e, em seguida, aumentá-lo assim que a crise diminui.

In some cases, employee compensation is an area that organizations tend to turn to for reducing expenses and controlling costs. However, leaders must consider their organization’s unique environment and specific communities when determining whether provider compensation cuts are prudent. Additionally, it is imperative that the organization consult its legal department prior to making any changes. Below are considerations for how to reduce compensation in the short term and then ramp it back up as soon as the crisis abates.

Se as organizações tomarem a decisão de usar as alterações de compensação como uma medida de corte de custos, há duas maneiras pelas quais a compensação de assistência médica deve ser modificada: compensação reduzida e fércia. Reduzido, considere a introdução de reduções percentuais para remuneração de fornecedores de prática (APP) médicos e avançados. Se possível, não exceda as tendências do mercado, pois isso pode afetar negativamente a cultura e a retenção do provedor. de compensação à produtividade.

Considerations for Amending Compensation

• If compensation must be reduced, consider introducing percentage reductions for physician and advanced practice provider (APP) compensation.
• Evaluate if reductions, regardless of productivity or current patient volume, will be applied across all provider types, including front-line providers.
• Identify and align the reductions to current market trends. If possible, do not exceed the market trends, as this may negatively impact provider culture and retention.
• Utilize a tiered model that may be phased in when expense reduction requirements increase.
• Consider how productivity and compensation are aligned.
• Align total compensation to a benchmark ceiling.
• Enforce a benchmark threshold of compensation to productivity.
• Reserve o tempo para reavaliar as diretorias médicas. O adiamento de salários e salários de bônus aumenta. Reduções (50% ou mais) em volume e determinam as necessidades apropriadas de pessoal. Todos os tipos de provedores são necessários.
• Consider aligning medical directorships to those required by regulations and what is needed to operate in the current environment.
• Ensure medical directorship compensation aligns fairly to benchmarks based on requirement versus a provider’s specialty.
• Consider potential and temporary deferment of bonus pay and pay increases.
• Determine if holding incentives and bonus pay until a future quarter is necessary to maintain required cash flow.
• Temporarily delay compensation increases.

Considerations for Furloughing

• Compare current and historical volumes.
• Identify clinics or other facilities that have had major reductions (50% or more) in volume and determine appropriate staffing needs.
• Consider team-based specialties (e.g., cardiology, orthopedics, etc.) and whether all provider types are needed.
• Revise a produtividade. Embora possam atender menos pacientes, eles também podem ter especialidades cirúrgicas incomuns, por exemplo. É nesse ponto que as organizações de saúde devem começar a aumentar a compensação do provedor para refletir as mudanças na demanda. Fornecedores previamente arrebatados com base no aumento da demanda dos pacientes. Para o próximo ano, com a intenção de aumentar durante o ano se a receita estabilizar e crescer. Necessário. Médicos, bem como taxas de compensação para aqueles que supervisionam vários fornecedores que realizam visitas de telessaúde.
• Evaluate furloughing tenured physicians with historically lower productivity.
• Be sure to consider multiple factors when reviewing provider productivity, as their contribution may not be readily apparent. While they may see fewer patients, they may also have uncommon surgical specialties, for example.

As the pandemic begins to recede and the industry transitions into the recovery phase, volume and mix of services will change significantly. It is at this point that healthcare organizations must begin ramping up provider compensation to reflect the changes in demand.

Increase Compensation by Specialty and Volume

• Determine where the organization is seeing the fastest and largest increases in demand.
• Increase compensation as specialty services approach previous volumes and productivity.
• Develop a thoughtful and strategic plan to bring back previously furloughed providers based on the increase in patient demand.
• Prioritize bringing back providers for strategic specialties that drive future growth.

Determine How to Calculate Compensation Increases

• Anticipate how crisis-related revenue losses will impact the coming fiscal year.
• Consider how to align base compensation to expected volume for the upcoming year with the intent to increase during the year if revenue stabilizes and grows.
• Introduce a compensation payout schedule.
• Create a timeline that enables the organization to maintain cash flows while delivering on compensation promises to providers (e.g., quarterly bonuses, incremental paycheck increases).
• Consider adjusting contracts as needed.
• Evaluate new and existing contract language to determine what might allow for compensation changes in the case of extenuating circumstances such as a pandemic.
• Determine if the contract renewal process should change as a result of effects of the crisis.
• Establish the compensation model for telehealth visits.
• Consider both individual compensation for physicians as well as compensation rates for those who supervise multiple providers performing telehealth visits.