Hospital-based physician contracts are often hospitals' most expensive and complex contracts. Finding comprehensive benchmarks and market data can be a challenge because these contracts have many different components, from compensation method to treatment of technical fees to incentives.
In the top fifteen most costly physician services, hospital-based contracts lead the pack.
Hospital-based physician services encompass specialties and services that are most often only provided in the hospital setting, with little or no separate independent or officebased practice. The MD Ranger Hospital-Based Benchmarks include the following hospital-based services:
- Anesthesia
- Emergency Medicine
- Pathology/Clinical Laboratory
- Radiology
- Hospitalists
- Intensivists
- Pediatric Hospitalists
- Neonatology
- Radiation Oncology
- Trauma Surgery
Hospital-based agreements include different types of services, ranging from clinical services, emergency coverage, and leadership/administrative functions. The graph below illustrates common types of services included in hospital-based arrangements, and the frequency in which they occur.
Organizations compensate physician groups for these types of services in different ways, adding further complexities to the contracting process. Furthermore, 20% of MD Ranger subscribers do not pay anything for these types of services. As you can see from the chart below, there is no uniform payment system for physician services, and the scope of many contracts requires responsibility for all coverage and administrative duties needed by the hospital for that service.
MD Ranger discovered that a growing number of hospitals are incorporating incentives into physician contracts. While only 11% of the hospital-based service contracts include incentive components, they have the potential to comprise a significant portion of contract payments. The most common metrics for incentive measurement include quality (86%), patient satisfaction (60%), and cost (31%). Incentives based on quality metrics have grown, while those for cost metrics have decreased since MD Ranger began collecting data in 2009.
Payments for providing uncompensated care are yet another element of hospital-based agreements. 19% of hospitalbased service contracts in our database include payments for uncompensated care.
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