MD Ranger 2018 Facility Total Benchmarks Release
MD Ranger’s Facility Total Benchmarks provide insight into how much hospitals spend on contracted physician services by category of service. A total spending amount is computed for each MD Ranger subscriber by summing estimated annual payments for all reported coverage, direction, and hospital-based contracts. The benchmarks report the distribution of facility total spending.
MD Ranger subscribers report that nearly half of all physician contract spending derives from hospital-based agreements. This segment, which includes hospitalists, intensivists, emergency, pathology, radiology, and other hospital-based physicians, is the fastest-growing physician cost in the MD Ranger benchmarks.
Call coverage payments continue to comprise a significant portion of physician contract costs. The scope and cost of call coverage varies dramatically by hospital size and other characteristics, which makes evaluating and documenting FMV and commercial reasonableness crucial to maintaining high compliance standards. MD Ranger benchmarks now include more than 55 call coverage services with a table that reports the percent of subscriber hospitals that pay for each type available as a tool to evaluate commercial reasonableness.
Directorship and administrative contracts are a much smaller slice of the total spending pie; however these payments also have been growing in both scope and amount over the past few years. Even though the overall spending levels on direction and administration are lower, compliance risks can arise if high payment amounts, inappropriate stacking of agreements, or payment for duplicate positions are issues. MD Ranger benchmarks include number of paid positions by service and total hospital payments by service to provide some guidance on commercial reasonableness and payment levels.
The 2018 MD Ranger total facility benchmarks are available for three bed size and average daily census metrics. Bed size slices include: fewer than 100 beds, between 100 and 300 beds, and above 300 beds. Average daily census slices are: under 75, between 75 and 150, and above 150. The slices were determined following review of data and determination of differences in hospital spending rates by size. These benchmarks will provide member healthcare organizations with more precise peer comparisons for facility spending and payment rates.
The size of a facility strongly correlates with physician contracting spending across call coverage, medical direction, and hospital-based agreements.
Hospitals that are designated as trauma centers (levels 1, 2, and 3) spend significantly more on physician agreements, especially for call coverage. The spending is a result of higher volume, burden of call, scope of services, and other market factors.
These unique challenges lead trauma centers to find particular value with solutions like MD Ranger, where they can use market data benchmarks to compare rates to similar hospitals.
Facility characteristics dramatically impact total annual payment medians. In addition to trauma status and hospital size (beds or ADC), MD Ranger data also provides benchmarks for Urban vs. Non-Urban location and Medicare percent of days, a surrogate for adverse payer mix.
Over the past three years, total physician payments are increasing, largely as a result of hospital-based physician contracts. These trends suggest a need for continuing vigilance to ensure payments are market-competitive and appropriate for your hospital and market. MD Ranger’s growing subscriber base and scope of service provide a ready source of market data benchmarks with a sophisticate toolkit to compare your organization’s payments with industry standards.