MD Ranger’s 2022 Report: New Benchmarks Suggest the Growing Scope and Complexity of Physician Transactions at Hospitals and Health Systems

MD Ranger announced the publication of new physician compensation benchmarks based on 2021 data. The report highlights the significance of physician payments as a major component of hospital spending, despite employment trends.  Hospital-based arrangements continue to grow in both scope and complexity, with the average hospital in the MD Ranger database spending just shy of $4.5m per year for hospital-based physician stipends. Hospitalists, Intensivists, and Anesthesia contracts comprise the largest expenditures.

MD Ranger’s 13th year of reporting features 1500+thousandsof benchmarks derived from a database of over more than 45,000 contracts from hundreds of over 225 hospitals and health care providers across the US, making it the largest and most comprehensive survey of non-salaried physician payments. Benchmarks include ED coverage, medical directorships, administrative services, hospital-based services, medical staff leadership, telemedicine, diagnostic testing, and clinical hourly rates. Salary and productivity benchmarks are also available and will be updated in the coming months.

Health care providers use MD Ranger’s benchmarks to set payment rates, document fair market value, and comply with federal Stark and anti-kickback regulations. MD Ranger is used by hundreds of healthcare organizations, including hospitals, health systems, trauma centers, medical groups, LTACs, outpatient providers, and critical access facilities.

The COVID pandemic impacted Infectious Disease payments, with median call coverage rates rising25% from a pre-COVID 2019 rate of $240 to 2022at $300 in 2021. Likewise, Infectious Disease administrative payments increase 20% at the median and 43% at P75, to $60,400annually. The rise in Hospitalist and Intensivist payments may also be the result of in higher COVID-related costs. Clinical hourly rates for Intensivists rose 28% at P75 to$250 per hour.

Key findings from the 2022 benchmarks include:

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• ED call coverage remains a significant expenditure with the average hospital spending nearly $4m for a year for coverage with twelve paid specialty panels.  Trauma centers spend considerably more – on average $7.7 million annually. Payment differentials can be large for some specialties: Orthopedic Surgery ED call rates at trauma centers are $2,680 at P75 and $1,200 at non-trauma centers at P75. 
• Despite increasing costs for ED call coverage, telemedicine is changing emergency call coverage panels for select specialties. With the increasing cost of ED coverage for stroke care and a limited supply of neurologists willing to take call, some hospitals have substituted or augmented neurology panels with telestroke providers. Median payments for neurology have stabilized at around $600 per diem while 75^th percentile payments continue to rise, with a 12% increase to $870 from 2021 to 2022.
• Critical Care/Intensivist arrangements continue to grow in scope. According to MD Ranger’s 2022 benchmarks, The median annual stipend payment for Critical Care is $988,600.  Five years ago in 2017, the median was $603,300, a 64% increase.
• While the number of medical direction positions at hospitals have increased over the years, physicians are generally spending less time in these     administrative roles. Since 2017, MD Ranger has observed decreases in annual hours across services although there are notable exceptions. Non-director administrative roles such as Care/Case Management, Utilization Management, and Quality Initiatives have all increased in annual hours.  Care/Case Management had the largest increase at 80% over a five-year period from 530 hours to 960 at P75.