告诉我们你在估值和薪酬云顶集团方面的职业和背景.
我的咨询生涯是从医疗保健期货开始的, 我的工作重点是医院合作和门诊护理战略规划. 我发展了许多云顶集团40011官网/医疗团体和医院/云顶集团40011官网之间的共同安排. 我还参与了专业云顶集团协议的工作, 管理云顶集团协议, 以及临床管理. 最终，我被综合医疗战略公司(Integrated Healthcare Strategies，现在的Arthur J. Gallagher，并能够深入研究提供者补偿，成为一个主题专家.
在加拉格尔的时候, 我参与了很多云顶集团40011官网团体的收购/结盟活动, 特别是在肿瘤学领域. 我还开始与接受联邦和州政府机构调查的医疗保健组织合作, 提供与云顶集团40011官网报酬相关的专家意见.
我建立了一家非常成功的咨询公司，但我知道在某些时候我需要采取行动. 我想成为一家专注于医疗保健的咨询公司的一员. 我一直很钦佩ecg，我经常听到业内同事说它始终关注文化. 我也非常钦佩心电图的专业广度. 为我的客户争取最好的结果, 我需要和其他领域的专家同事一起工作. 因此，当领导估值云顶集团业务的机会摆在我面前时，我欣然接受了! 在我的新职位上已经五个月了，我无法想象去其他任何地方.
医疗保健行业正在经历许多变化. 您预计2021年医疗保险医师收费表规则的变化将如何影响2021年的组织和估值?
首先, the COVID‑19 pandemic has caused an interruption in revenue over the past year that has required many organizations to shift priorities. 同时, 2021年MPFS的变化降低了医疗保险转换因子，同时增加了E的WRVU值&这些代码通常与初级保健云顶集团有关. 这两起事件促使全国各地的云顶集团40011官网重新评估它们与患者的关系, 纳税人, 和云顶集团40011官网.
总的来说，许多客户仍然对疫情感到疲惫. Most organizations we work with have decided to keep administering physician productivity-based compensation on the 2020 Medicare Physician Fee Schedule—mainly to buy time.
The 2021 Medicare Physician Fee Schedule changes will have near- and long-term effects on market compensation and benchmarks. 第一个, 到2021年, compensation agreements will need to be reviewed and adjusted to balance the financial and compensation-related impacts of these changes. 第二个, 在2023年之前，wrv和收集的基准值将不能代表市场，并且可能不可靠, 最早. 第三, the financial impact and revenue shift will drive physician groups to consider tying total group compensation to professional fee revenue. 和, lastly the dual shock of COVID-19 and the 2021 Medicare Physician Fee Schedule changes will enhance the attractiveness of a diversified compensation model, 特别是如果更多地强调基于价值的组件.
从估值的角度来看，我们建议组织不要挑选赢家和输家. 目前, 组织倾向于优先考虑专业云顶集团安排，而不是雇佣网络. 有关专业云顶集团安排, it is common for us to be asked if it is reasonable to allow the 2021 Medicare Physician Fee Schedule to go into effect—in most cases meaning increased WRVUs—with no adjustment to the compensation per WRVU rate. 我们对组织的直接问题是, 他们如何对待他们的其他专业云顶集团安排和雇佣网络? 我们强烈建议保持一致性. An equitable and fair plan will minimize the risk of disgruntled physicians and thus the increased risk of a qui tam complaint (e.g.告密者). Physicians have generally been accepting of the delay in implementation of the MPFS changes—mostly due to the goodwill most organizations provided through compensation guarantees in 2020 because of the pandemic. 这种善意似乎正在减弱，如果有一种不公平的感觉，这种善意将完全消散.
How have the recent changes in the Stark and antikickback regulations impacted organizations’ approach to compensation arrangements and risk tolerance?
It has started to level the playing field for nonprofit healthcare systems in how they can compensate their physicians under value-based arrangements. Private/for-profit organizations have long had the advantage of tying physician compensation to improved cost savings and quality goals. The regulatory change allows nonprofit organizations to compensate physicians for value-based activities for a target patient population without requirements of fair market value or restrictions on volume or value of referrals.
The regulatory changes have increased the risk tolerance for many around some key opportunities—gainsharing/shared-saving arrangements, 均摊, 合资企业. 心电图 has a proprietary financial model that quantifies the value of moving patients from fee-for-service to value-based arrangements based on a hypothetical market participant. This model is assisting in practice acquisitions in primary care and encouraging physician compensation models to be aligned with total-cost-of-care goals.
你能描述一下与covid相关的豁免是如何影响组织对第三方FMV审查的需求的吗?
3月30日, 2020, CMS issued blanket waivers to temporarily exempt healthcare providers from fair market value considerations for compensation paid from an entity to a physician for medically necessary patient care services when directly impacted by the COVID‑19 pandemic. The purpose of the blanket waivers is to ensure that sufficient healthcare items and services are available to meet the needs of individuals in the emergency area and that healthcare providers that furnish such items and services in good faith may be reimbursed for such items and services and exempted from sanctions for such noncompliance. 这一豁免取消了针对COVID - 19的公平市场价值考虑, 例如确保云顶集团40011官网提供医疗上必要的病人护理云顶集团, 包括与COVID - 19诊断和治疗无关的云顶集团, 以应对美国的COVID-19疫情.
根据我们的经验, 虽然许多组织依靠豁免作出各种安排, 对第三方评论/意见的需求几乎没有影响.
What suggestions do you have for organizations to ensure compensation models remain compliant with all these changes occurring?
快速的答案是拥有可靠的提供者薪酬治理和管理流程.
由于监管变化带来的所有不确定性以及大流行的持久影响, 我们的许多客户正在暂停并重新评估他们现有的薪酬治理和管理流程. Essentially working to align with regulatory requirements while minimizing the unnecessary need for third-party reviews and their corresponding costs. 目前, we are working with two the nation’s largest nonprofit organizations to strengthen their internal policies and management processes for reviewing and administering physician financial arrangements and meeting compliance needs. Our recommendations aim at balancing workload and standardizing administrative processes related to physician contract reviews and renegotiations, and are informed by 心电图’s experience reviewing hundreds of examples and serving as an expert witness in federal and state investigations, 还有我们的案件和和解数据库.
心电图还做了什么来帮助客户应对这些变化?
虽然一些组织在以价值为基础的护理安排方面引领市场, 其他公司仍主要依赖于按云顶集团收费的报销环境. 我们有必要确保这一点, 随着按云顶集团收费的报销减少, 薪酬计划和供应商激励与实际报销方法保持一致. These value-based care arrangements not only align with the future of payer reimbursement but they also incentivize the right care for patients.
除了我之前提到的工作, 我们正在协助进行全面的薪酬重新设计，并朝着共同的理念进行调整. 在这个组织内, 我们仍然需要系统化——更紧密地联系在一起, 一个组织承担全部健康风险的全面综合保健云顶集团集合, 幸福, 和成本, 在与顶级国家组织以及许多新进入市场的“颠覆者”组织竞争的同时. A unified philosophy and compensation framework will help align provider arrangements with the overall goals of the organization. 另外, 通过确保没有利益相关者是孤立的, 该框架将有助于竞争性薪酬, 透明度, 以及整体提供者满意度.
Healthcare organizations have an immediate opportunity to capitalize on recent market changes and align provider compensation with the future enterprise strategy. This alignment will ensure an increased level of systemness that is required for long-term success of any physician enterprise.
2021年3月22日发布