wRVU calculations in APM model

[XRT_doc]

How will the wRVU's bee calculated in the APM model?

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[firewicket]

Umm...There isn't a RVU? There is just a lump sum Cash payment.

 

[RadDoc11]

Umm...There isn't a RVU? There is just a lump sum Cash payment.

how do you think hospitals will try to account for productivity in determining physician salaries? I personally find the rvu model to be flawed in radiation oncology. Being at though we are at the end of the food chain, we often have little control over patient volumes. They can depend heavily upon for example whether your hospital has hired urologists vs whether there is a urorad across the street etc etc.. I also think it can influence docs to do unnecessary imaging, avoid hypofractionation, etc.
I understand that employers (hospitals) want to incentivize people to work, but I don’t think this is the proper way to do so in rad onc.

I wonder how this will change with APM? Will they measure us based upon the number of patients seen? Of course I anticipate salaries declining..

 

[SneakyBooger]

Who knows.

Who knows if APM will ever be implemented. If implemented, how long will it last. If it lasts, how quickly it will change.

Although it is definitely going to hurt from the get go, I suspect it will be many years before we feel the full burn.

Exciting disrupting times for rad onc!

We should keep the good times rolling with a MOC thread!

#RadOncAPMRocks!

 

[radoncgrad2019]

it will be implemented, no doubt.

 

[evilbooyaa]

In places that control the payments (private practices) there might be a chance for salvage and stabilization of salaries. I think for employed models it will be more problematic.

 

[PhotonBomb]

In places that control the payments (private practices) there might be a chance for salvage and stabilization of salaries. I think for employed models it will be more problematic.

explain?

 

[evilbooyaa]

explain?

With the loss of a wRVU system that is frequently used for those in employed situations to calculate their requirements for salary and incentive metrics (given a standard $/RVU for the area/institution), there is greater opportunity for obfuscation of how much money an institution is bringing in, and thus, how much money is passed along to the physician.

In the past, the more work you did meant that you got paid more. How this will change in APM is anyone's guess.

In a private practice, you at least know where all the APM collections will end up.

 

[XRT_doc]

Most private practice docs don’t own the equipment and those that do are dying at a blistering rate. So the APM model will still affect almost all of the private practice docs since the equipment is owned by the hospitals. So how would the split happen between the hospital and the private practice group that provides professional services. Ofcourse no one knows but don’t fool yourself, this will affect all radoncs the same way. Unless ofcourse youre already being screwed by your employer and don’t get paid based on production.

 

[BobbyHeenan]

Most private practice docs don’t own the equipment and those that do are dying at a blistering rate. So the APM model will still affect almost all of the private practice docs since the equipment is owned by the hospitals. So how would the split happen between the hospital and the private practice group that provides professional services. Ofcourse no one knows but don’t fool yourself, this will affect all radoncs the same way. Unless ofcourse youre already being screwed by your employer and don’t get paid based on production.

There is a separate fee schedule for pro fees and technical fees for APM.

So if you’re billing separately as a PSA there’s no “split.”

 

[XRT_doc]

There is a separate fee schedule for pro fees and technical fees for APM.

So if you’re billing separately as a PSA there’s no “split.”

How does that fee schedule compare to the pre-APM era

 

[BobbyHeenan]

How does that fee schedule compare to the pre-APM era

It’s very hard to compare exactly. You can find the fee schedule in the documents. In the current scheme on the pro side you bill for all kinds of stuff like masks, mlc, wedges, the plan, under treat visits, even concurrent chemo. With APM it’s just 1 thing to bill . I’d link the .pdf but don’t have it in front of me.

For most things it’s a pay cut (long course lung, head and neck, cervix). For some things maybe a minor bump (3D or IMRT apbi), single fraction 3D palliative bone met, whole brain.

Very hard to calculate it all out but make no mistake, it will likely reduce professional collections. Exactly how much will be practice to practice dependent. If you’re heavy into long course breast or prostate you’re about to get a big haircut.

 

[SneakyBooger]

you’re about to get a big haircut.

Everybody is about to go bald.