Meaning of RVU national percentiles relative to 'work'-volume

[PreHippocrates]

Greetings.

Hoping someone can clarify the meaning of this for me. Looking at an outpatient child job that eventually has a required RVU for base pay, and I was told that it was X percentile of the national average of RVU. I'm not sure where I would get ahold of such figures, and more importantly, how to translate that into seeing Y number of patients per week, or having Z number of patient-facing hours per week. I'm aware of the fact that depending on how I bill and how many patients I see per day or per hour, my RVUs can vary widely.

Given various percentiles of 'the national RVU psychiatry average,' how would 'work-volume' translate to, say, the 30th, 50th, or 70th percentiles?


Hope the question makes sense.

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[splik]

You can't. Forget about all that. It's all smokes and mirrors. What matters is what is your conversion factor (i.e. $ per wRVU). You need this to figure out what your compensation would look like accounting for the number of pts you see and codes used. It is pretty common to have a salary guarantee for 1-2 years before being required to make wRVUs so you don't lose money while building your panel.

 

[SmallBird]

It is unfortunately not at all paranoid to believe that hospital administrators lie about how these systems work in order to avoid more honest statements. I left hospital systems not because of bad pay but for a lack of a candor and a style of communication around compensation that was infuriating and made me feel angry even on days I was happy with my pay. Varieties of 'smoke and mirrors' include the now prominent trend of systems increasing RVU targets in response to medicare adjusting the RVU values for certain codes, which completely undermines the point of medicare trying to balance out discrepancies between workload assumptions for procedural and primary care specialties.

One hospital I worked at would decrease the $/RVU for your work the more you did. So when I started and had a low target of like 3000 RVUs I was paid like $60/RVU approximately. Of course the workload was much higher but extra RVUs were only compensated at $35/RVU. Then if your contract got renegotiated they would present you with a 'big raise' but it would be a 4000 RVU target now at $55/RVU. They would frequently be surprised that almost every provider found that unfair and ultimately was super demoralizing.

Another system I worked in was a University that got paid a certain $/RVU by the hospital we all worked at and the pooled the money and decided how to pay it out. Some people were doing 1000 RVUs a year and I was doing about 4000 but of course pay was not reflected in that. I actually didn't think my pay was too bad but the lack of transparency and unfairness was infuriating.

Now I work at a big system that, while being a bureaucracy, is a functional one. Its sort of like if you assume that you have to accept the insurance based medical system that the US has, I think my current system is about as good as you can do for patients and providers. We are paid a good amount of $/RVU and it gets adjusted annually but doesn't cap or get reduced at certain volumes. If you do extra work you get extra pay. If codes increase in value then you get more RVUs. If you don't like the amount per RVU then you are out of luck but it is so much better for my mental health being a system that is this transparent. There are doctors may huge amounts of money for huge amounts of RVU and as long as their quality remains good nobody brings up nonsense about fair market value.

 

[forchinet121]

It is unfortunately not at all paranoid to believe that hospital administrators lie about how these systems work in order to avoid more honest statements. I left hospital systems not because of bad pay but for a lack of a candor and a style of communication around compensation that was infuriating and made me feel angry even on days I was happy with my pay. Varieties of 'smoke and mirrors' include the now prominent trend of systems increasing RVU targets in response to medicare adjusting the RVU values for certain codes, which completely undermines the point of medicare trying to balance out discrepancies between workload assumptions for procedural and primary care specialties.

One hospital I worked at would decrease the $/RVU for your work the more you did. So when I started and had a low target of like 3000 RVUs I was paid like $60/RVU approximately. Of course the workload was much higher but extra RVUs were only compensated at $35/RVU. Then if your contract got renegotiated they would present you with a 'big raise' but it would be a 4000 RVU target now at $55/RVU. They would frequently be surprised that almost every provider found that unfair and ultimately was super demoralizing.

Another system I worked in was a University that got paid a certain $/RVU by the hospital we all worked at and the pooled the money and decided how to pay it out. Some people were doing 1000 RVUs a year and I was doing about 4000 but of course pay was not reflected in that. I actually didn't think my pay was too bad but the lack of transparency and unfairness was infuriating.

Now I work at a big system that, while being a bureaucracy, is a functional one. Its sort of like if you assume that you have to accept the insurance based medical system that the US has, I think my current system is about as good as you can do for patients and providers. We are paid a good amount of $/RVU and it gets adjusted annually but doesn't cap or get reduced at certain volumes. If you do extra work you get extra pay. If codes increase in value then you get more RVUs. If you don't like the amount per RVU then you are out of luck but it is so much better for my mental health being a system that is this transparent. There are doctors may huge amounts of money for huge amounts of RVU and as long as their quality remains good nobody brings up nonsense about fair market value.

What’s the pay per wrvu where you are?