[MCOH-EH] RVU/Incentive Based Models for Employee Health/Occupational Medicine

[Robert Filler]

Short version: My experience with RVUs in MCOH was unpleasant.

I signed on with a hospital with a productivity based incentive among
others. They shut down the external client operations which made it
somewhat hard to be "productive" when a large piece of our business went
away, I was fortunate to not be in the laid off portion of staff. Over the
next few years the dept pivoted to quality improvements to be productive
with our new free time instead by preventing internal staff injuries and
optimizing care which further decreased visits, while losing compensation
for low productivity at times as incentives changed. We yielded possibly
better safety but definitely lower average claims costs. It was still a bit
of a fight to show that looking at $1,000,000 in decreased claims costs in
my last year there might make more sense than continuing on with more
abstract productivity measures that don't value prevention. The
argument that RVUs correspond to money was not accepted in reverse order
(AGMA has tables published on the value of RVU so you can math it out). Our
Epic build also somehow didn't capture WC RVUs accurately (I had 3.7 RVUs
for one entire fiscal quarter which despite the obvious absurdity wasn't
even double checked) and the employee health EMR didn't report it well
either as best we could tell. The silly thing is I could have had patients
come back at more frequent intervals costing the system money but
optimizing by RVUs for compensation, if the RVU counting had worked
correctly. I personally will endeavor not to practice a prevention based
speciality in a production based model based on that experience.

I would think one would really need to carefully look at what their
specific clinic does and if RVUs accurately capture the totality of value
output better than other measures.

Thanks,
Rob

Rob Filler, MD, MBA, MPH
OccMedSource
robert.filler at gmail.com


On Tue, Jan 28, 2025 at 1:11 PM Haq, Farah via MCOH-EH <mcoh-eh at mylist.net>
wrote:

> Good Afternoon,
>
> Does anyone have experience with any RVU or incentive-based models for
> medical center employee health and/or for occupational medicine (not
> limited to medical centers)?
>
> We are looking into possible salary plus RVU or
> productivity/incentive-based pay for our providers but are not familiar
> with models that may work for employee health.
>
> Thank you,
>
> Farah
>
>
>
> Farah Haq MD, MPH
>
> Division Head, Occupational, Environmental and Clinical Preventive Medicine
>
> Clinical Assistant Professor
>
> Dept. of Family, Population and Preventive Medicine
>
> Stony Brook Medicine
>
> This email is subject to the confidentiality provisions noted below
>
>
>
> This e-mail message, including any attachments, is for the sole use of the
> intended recipient(s) and may contain confidential and privileged
> information and or information used solely for quality assurance purposes.
> Any unauthorized review, use, disclosure or distribution is prohibited. If
> you are not the intended recipient, please contact the sender by e-mail and
> destroy all copies of the original.
>
>
> ---------------------------------------
> The MCOH-EH List has always been moderated by members of the ACOEM Medical
> Center Occupational Health Section. It is currently moderated by Joe
> Fanucchi MD FACOEM.
> List membership is free, but only subscribers may post to the list.
> To post send messages to: mcoh-eh at mylist.net
> To become a subscriber, or to change your subscription options (turn off
> email while you're on vacation, etc):   http://www.mcoh-eh.net
> MediTrax / Occupational Health Systems, Inc. provides financial support to
> ensure the list remains a free resource for the occupational health
> community.
> ---------------------------------------
> List archives (public): http://mylist.net/archives/mcoh-eh/
> ---------------------------------------
> Send administrative requests to: drjoe at meditrax.com
> ---------------------------------------
> When replying to a message, PLEASE delete all footers, and all messages to
> which you're NOT replying.
>
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://mylist.net/archives/mcoh-eh/attachments/20250128/47838aa0/attachment-0001.htm>