Docs in Productivity Models Likely to Encounter Compensation Caps

Physicians, especially those working in a productivity model, must understand compensation caps

MONDAY, Sept. 21, 2015 (HealthDay News) -- Physicians, especially those working in a productivity model, need to understand compensation caps, which are set at a specific percentile of national pay based on surveys, according to a report in Medical Economics.

Physicians working in a productivity model are the most likely to encounter caps, which can be "hard" -- i.e., a definite stopgap on paying anyone over a certain percentile of a specific survey -- or "soft," meaning that after hitting the cap, work will be reviewed to see whether the pay is justified.

For physicians who are consistently hitting a percentile cap, the employer may want to explore the reasons. Sometimes it results from physicians being very hard workers, having excess patient demand, or inadvertently upcoding in ways not supported by the documentation. When a physician hits a rigid cap, there is no incentive for him or her to continue working; a monthly or quarterly cap with a rolling reconciliation set up by nonprofits can be used to avoid this problem, as can adjustment of the conversion factor.

"If there is a significant disconnect between the work that physicians are doing and the compensation they earn, that's where there is a concern, as opposed to someone who is blowing the doors off doing great work and who deserves the money," Mark Mertz, M.H.A., vice president of The Camden Group, told Medical Economics.

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