Paid on Productivity NPs

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    Are any of you paid on productivity. If so, what is your percentage? Do you also have a base pay amount?

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  2. 7 Comments...

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    I have a base salary and can earn up to 100% of my base in potential bonuses on a quarterly basis based on a complex formula of RVUs, meeting meaningful use and quality improvement goals, and patient satisfaction markers. I average about 60% because I don't care to work hard enough to go after the other 40. There are providers in the group that get there, but I think almost 100% of them are single, and fairly young. It takes an enormous number of patient visits and chart perfection to get there.

    I am acquainted with one provider who did do it in a 40 hour work week with an interesting approach others are considering; he hired a scribe out of his own pocket. He is in adult/internal med, and routinely sees 45-50 patients a day, 5 days a week. His charts are perfection, and he somehow bills all of these visits as 99214s, even though we have calculated if he eats lunch and uses the bathroom twice daily, these visits cannot possibly extend beyond an average of 8 minutes each. He is also never behind schedule. He is something of a legend. His patients hate him, but his panel is full. Go figure.

    Anyway, the answer to your question is going to vary. As our formula depends on several factor including the company's overall quarterly collections and profit margin. I am not paid a direct percentage of productivity, so I cannot give you a direct answer.
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    Base with 50/50 split of collected billing after 250k.
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    Thanks for the responses. The proposal is 50% of the profits of billed services, and they want me to come up with an amount for base payment each month (what I think I should get). I am used to a system with RVUs, but this unfamiliar territory. There is also potential for ownership. @ DNP: I know a physician that is a machine like that, he can treat 'em and street 'em and his patient satisfaction is amazing. Although I would agree on the 99214 visits...
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    If it helps in your figuring, I see about 55% 99213s, 35% 99214s and 10% 215s. I am a .8 FTE and I see an average of 90 visits a week. I bill about 90K a month for the practice, give or take, depending upon how many procedures I do. Even accounting for my part-time status, I am not nearly the biggest earner in my practice mostly because I see a lot of well children. Go for sick(er) adults with multiple co-morbidities and you will bill a larger number of 99214s. If I were concerned about that issue, I would not opt to do well child visits, lol. As it is, they are the highlight of my day!

    In defense of my productive colleague referred to above; he is not popular, but he is one of the most gifted diagnosticians in the field. He has a subspecialty in lipid management, so he does get a lot of supersickies, and can nail them for multiple diagnoses (dyslipidemia, HTN, DM, macro/micro vascular dz, renal failure, etc). People go see him for his expertise in spite of the fact that he is a bit of a jerk, lol. He is a scientist foremost. I think the fact that he gets it right the first time and spares them the tedium of his company on multiple visits is a plus. People also like it that he is on time. More dependable than the MAX train! If your appointment is at 9:00am, I think there is something appealing about being seen at 9:00am and out the door at 9:10!

    I don't have any experience negotiating that kind of contract, but somewhere on this site David has given outstanding advice on that in the past. I am sure if you search you will dig it up.
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    Thanks for the stats and advice. I am part time as well, so I am a little concerned about numbers. I will see if I can find David and some contract negotiation advice. I did enjoy the simplicity of a hospital based system, but venturing out into a private practice again is *hopefully* a good move.
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    I'm a new grad NP and had my first interview yesterday. The job is with a private practice physician who sees patients at something like 10+ facilities (inpatient, SNF, ALF, and outpatient in his office too). I really don't know much about the contracts/negotiating/business aspect of this. He offered me a job and gave some options of how I could work with him. One option was salary at $100,000/yr. Another is entirely productivity pay at 70% of billing after overhead. Benefits seem less than desirable in both scenarios since he is the only provider and there is no 401k or group health insurance rate. I think if I went with the salary option I would ask for productivity bonus. Does either option sound good to start? What else should I ask for in my contract?
  9. 0
    After browsing this tread... how ironic is it that I see this article in a newsletter that I subscribe to daily. Apparently utilizing scribes is the new "hot" trend....

    http://www.nytimes.com/2014/01/14/he...e.html?hp&_r=0


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