Yesterday we celebrated the tenth anniversary release of MD Ranger physician contract benchmarks for non-salaried physicians. Our 2019 report highlights the growing significance of physician contracts as a major component of hospital spending, with particular growth in payment for hospital-based physician services such as hospitalists, intensivists and laborists. Benchmarks include payments to physicians for providing ED call, medical directorships, administrative services, hospital-based services, medical staff leadership, and diagnostic testing.
2019 benchmarks cover more than 320 services derived from over 36,000 contracts from 250 facilities in 32 states across the US, a tenfold increase since we launched in 2009.
Joe Piccolo, Vice President of Corporate Compliance at Inspira Health in New Jersey, commented, “Working with MD Ranger has allowed Inspira to standardize and streamline our physician contracting process. Not only do we have access to the best available market data, but the customer support in understanding how to best use the benchmarks has been outstanding. Working with MD Ranger makes my job easier and gives our leadership team peace of mind."
While many things have changed in healthcare over the past ten years, our benchmarks demonstrate the scope of services that health care facilities continue to procure from physicians. Key findings from the 2019 benchmarks include:
- Size matters. While hospitals under 100 beds pay for fewer services, their cost per patient day is significantly higher. For example, the median payment for Pathology contracts at hospitals with more than 300 beds is more than twice the payment for hospitals with fewer than 100 beds, but the cost per patient day is more than seven times higher.
- Average per diem ED call rates for medical subspecialists have increased 40% over the past ten years from an average of $414 per diem to $580, compared to less than 8% for surgical subspecialties, from $854 to $920. Hospital-based coverage rates have grown from an average of $783 per diem to $980, a 25% increase.
- The past decade has seen a huge growth in the scope, complexity and cost of hospital-based agreements. Hospital-based services comprise the largest category of physician contract cost; for example, 63% of MD Ranger hospitals reported payment for general hospitalists programs at an average cost of $1.55 million.
- Psychiatric hospitalist programs as well as ED per diem payments have grown more than any other service, with mean coverage payments increasing nearly 95% from $171 to $330 per diem since 2009.
- Payments for interventional services such as neuro-interventional, interventional radiology, and stroke-related services continue to grow. For example, in 2015, only 4% of MD Ranger participating hospitals paid for neuro-interventional call coverage while in 2019, 17% paid.
- Payment rates for medical staff officers and leadership positions were relatively constant, with 46% of MD Ranger hospitals paying a Chief of Staff an average of $48,000 and 31% paying an average of $20,000 for other medical staff officers.
A selection of the 15+ new 2019 benchmarks include:
- Neuro-Interventional Medical Direction
- Stroke ED Call Coverage
- TAVR Medical Direction
- Heart Failure Program Direction
- Adult and Pediatric Echocardiogram
- Intraoperative Neuromonitoring Technical Fees