I work in primary care for a hospital-owned medical group. I have a meeting Friday with the director of our medical group. Our RVU policy is currently garbage. Maximum amount that can be earned is $30,000 per year for NPs (Physician RVU is unlimited) and if one makes over $100k, the RVU is prorated. So if you make $130k, you get no bonus at all.
I just ran my numbers in Epic. This fiscal year, which doesn't even include the rest of December, I've billed $1,182,026 and $621,000 of that was collected. At this rate, I earn over $1.2 million a year for the practice. I currently make $125k/ year plus a $5k bonus. I get 216 hours of PTO, $2500 and 5 days for CME and health insurance (I still have to pay premiums, they just cover part of it), as well as STD and LTD, etc.
I've read that we should try to get 20% of what we bring in to the practice. Is this correct? Based on that, I should be earning $250k/year. With what I'm bringing in, would I be considered extremely productive? I earn 50-100% over my required RVU targets. Can I go into this meeting and show them what I'm bringing to the table and ask for a raise or at least an improvement in RVU structure to be unlimited. If I subtract the total cost of all my benefits (about $35,000 a year), I'm still WAY under the $250k/ year, if it is reasonable to ask for 20% of what I bring in. What do you think? Is the 20% thing only when one doesn't get offered benefits?
Any insight would be appreciated as I have this meeting on Friday.
In that job I got benefits. In my current one I do not but it is by choice. I know my figures are on the high end and not the norm. I don't know where you are located so I can't tell you what the market is. Every market is a lesson in microeconomics. You can always ask. They can always say no. If you don't ask you'll never know but I think 20% is reasonable. If you have skills other NPs don't you can ask for more. The owner of the practice knows what you bring in to his bottom line. He wants to maximize it. You want to maximize your earnings. There is a happy medium but like I said earlier always be prepared to walk away ONLY if you have another job immediately available. Good luck. Negotiations aren't for everybody and most nurses accept what ever is offered. I never have.
I live in the NYC metro area, high cost of living. Can I ask for the 20% AND benefits as well? the 20% would be more than the physicians in the practice are making. So I don't know if this makes sense. I don't have another job lined up except for a possible full-time online telemedicine job, but can't walk away right now. So should I not ask for a raise if I'm not ready to walk away?
You can ALWAYS ask but if you are asking for more than the MDs make I doubt they will give it to you. Where i was working the cosmetic dermatologists were netting $900,000 to $1,000, 000 a year just to give you some perspective.
I work in primary care for a hospital-owned medical group. I have a meeting Friday with the director of our medical group. Our RVU policy is currently garbage. Maximum amount that can be earned is $30,000 per year for NPs (Physician RVU is unlimited) and if one makes over $100k, the RVU is prorated. So if you make $130k, you get no bonus at all.
I just ran my numbers in Epic. This fiscal year, which doesn't even include the rest of December, I've billed $1,182,026 and $621,000 of that was collected. At this rate, I earn over $1.2 million a year for the practice. I currently make $125k/ year plus a $5k bonus. I get 216 hours of PTO, $2500 and 5 days for CME and health insurance (I still have to pay premiums, they just cover part of it), as well as STD and LTD, etc.
I've read that we should try to get 20% of what we bring in to the practice. Is this correct? Based on that, I should be earning $250k/year. With what I'm bringing in, would I be considered extremely productive? I earn 50-100% over my required RVU targets. Can I go into this meeting and show them what I'm bringing to the table and ask for a raise or at least an improvement in RVU structure to be unlimited. If I subtract the total cost of all my benefits (about $35,000 a year), I'm still WAY under the $250k/ year, if it is reasonable to ask for 20% of what I bring in. What do you think? Is the 20% thing only when one doesn't get offered benefits?
Any insight would be appreciated as I have this meeting on Friday.
I don't think you've included ALL factors into your equation...
From what you've calculated, you will need to subtract what the practice ACTUALLY collects from insurance companies who pay. Some don't pay at all, others don't pay in a timely manner, etc.
What is the practice's overhead costs? Because best believe, that will be subtracted from what you've projected you bring into the practice.
For more info on costs factors and negotiations, I recommend reading Cathryn Buppert's book: Business Practices and Legal Guide.
Quite Frankly, expecting to get $250,000 in primary care, the least compensated specialty, is a far reach. Especially since that is the average pay for family practice physicians.
But hey, guess it doesn't hurt to ask....
....Well, unless they let you go, and you don't have another job lined up??♀️
Wow, I currently just make a salary with no RVU compensation. I am a high producer due to both patient volume and billing and I asked for a 10% raise to accommodate for the fact that RVUs are not factored into my salary (still would be much less than OP salary). Presented numbers/graphs and all. I got a hard no within the day "Impressive presentation! unfortunately, our compensation is not structured to recognize production for your role at this time, we anticipate to be evaluating this over the coming years"
I am not particularly motivated by money, but the injustice of the current compensation system and the pacifying answer was disappointing to me. I have some other priorities currently, but my loyalty is limited at this point. Nurse practitioners are cash cows for medical corporations and I don't anticipate them easily giving up their favor in the current compensation system. The problem is they also get bridled down with low producers in this role who are likely overcompensated and have little motivation to increase their production. There has to be a middle ground that is fair for all
Finally, an interesting and thought provoking thread here. This is what I have been going over in my head the last few weeks, esp since I am now in a small office where the APRN runs the place and has 4 pts on average per 7 hours... her delegating physician is "retired." I'm trying to figure out what she makes.
I feel the big issue is since the salaries are already "good" ; in TX where COL is dirt cheap, I was offered around 130k... and most of my class thinks "WOW that's great!!" When in reality, we are generating 2 to 3 times this amount. I know there are other factors but something doesn't seem right. Esp when I see the doctors and they literally do the exact same thing that I am doing. I Mean yeah, they have a tad more experience and more in depth knowledge. But I can't help but imagine how underpaid we are considering if you put in the time you will become just as knowledgeable. Not to mention this is "practice" and there is no magic bullet.
I think the biggest issue here is the supply, and the fact that most other people will jump at anything around 100k. Esp nurses who don't know what they are worth and won't bargain or say no to an offer.
googs
48 Posts
I live in the NYC metro area, high cost of living. Can I ask for the 20% AND benefits as well? the 20% would be more than the physicians in the practice are making. So I don't know if this makes sense. I don't have another job lined up except for a possible full-time online telemedicine job, but can't walk away right now. So should I not ask for a raise if I'm not ready to walk away?