Pay per visit vs hourly/salary

[Raine Higham]

Can anyone tell me the pros of pay per visit ? I've only been salary in the field so this concept is new for me.  Not sure it's beneficial or not.  Thank you in advance. 

[ponderingDNP]

My short sprint through home health didn't reveal any pros to this pay model. I found it to be, in MY opinion, only beneficial as supplemental income where it co-exists in a household with a full salary, and a significant need for a work-life balance.

My revelation came when two of my ONLY TWO scheduled patients for the day cancelled/rescheduled: ZERO dollars for the day even though I reported for work. As the sole source of income in my home, given that I live alone, pay per visit model quickly (almost instantly) became one of the very few required nails in my home health coffin.

[jbudrick, MSN]

Hello Raine:

Pay per visit can be beneficial as long as your patients keep their appointments and the visits go quickly, without excessive driving.  When you get the patient who is not home for the visit or has time consuming needs, you lose.  

At the agency where I work full-time RNs are salaried and have a productivity requirement and full benefits.   If productivity is under the nurse can use PTO or in some cases administrative time.  If their productivity is over, they get paid per point.  

Per diem nurses ask for start of cares or the number of visits and risk not making money.  We usually have lots of work and "fall-out" visits are quickly replaced.  Rarely the per diem goes home empty handed.  

Best wishes,

Budcoupon

 

[SuzanneRNLA]

The Agency where I last worked Home Health started out as pay per visit. They got sued (not by me) because they didn't take in account driving time between patients, or documenting time. They lost, and they went to hourly pay, which was way more beneficial to clinicians. I'd probably never take a pay per visit job again! I don't know where you live, but this was in California. Good luck!

[MrChicagoRN, RN]

Take your daily salary, $500 for example, and divide it by the PPV.

How many visits per day would you need to do to meet/exceed your salary. Is that doable? If you needed to do more visits to make the same money, that's not a good deal. 

Per visit often works best when the visits are close, and very brief. For example med fill and BP checks in an independent retirement hotel.