REPORT: 2015 Cardiovascular Provider Compensation

[Pages:44]REPORT:

2015 Cardiovascular Provider Compensation and Production Survey

FORWARD

A Wealth of Information

By Joel Sauer

MedAxiom is proud to be publishing its 3rd annual Cardiovascular Provider Compensation & Production Survey. These data, obtained from our vast cardiovascular membership, provide invaluable peer comparisons to programs trying to manage themselves at peak performance--more and more a prerequisite for success in the tightening economics of healthcare.

Joel Sauer

VICE PRESIDENT

MEDAXIOM CONSULTING

With each iteration of our publication MedAxiom attempts to refine and expand the data available, and this year's survey is no exception. For the

first time this survey contains valuable data for non-clinical compensation,

including administrative (leadership) positions, medical directorships and at-risk incentive

compensation. This information provides critical insight into value-oriented compensation for

our fair market valuators, allowing programs to better align provider compensation with the

new value economy.

Additionally, MedAxiom added a structural heart (TAVR) filter to its database, allowing direct comparisons between programs with and without these services. This granularity gives a more accurate peer assessment for important measures like diagnostic testing patterns, work and compensation.

Pushed in large part by Medicare's rapid transition from volume-based reimbursement to one tied inextricably to value (quality, cost, service), healthcare as an industry is changing at an unprecedented pace. At MedAxiom, we believe data sharing and peer-to-peer networking provide the most powerful means for advancing cardiovascular programs nationally. Our sole focus on the cardiovascular segment allows us to get extremely deep and detailed into that world, providing our members with a wealth of useful and relevant metrics. This publication is just one example of this powerful network.

MEDAXIOM CARDIOVASCULAR PROVIDER COMPENSATION & PRODUCTION SURVEY ? 2015

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CONTENTS

Contents

Forward ................................................................................................................. 3 Survey Highlights & Insights.................................................................................. 7 1. Aligning Economics with Value: The New CVSL Imperative ............................. 9 2. Overview of the Report .................................................................................. 14 3. Survey Results ? Cardiology ........................................................................... 16

Ownership Comparisons ................................................................................ 16 Subspecialty Breakdowns............................................................................... 18 Changes by Geography ................................................................................. 19 Key Volumes & Ratios..................................................................................... 20 Panel Size ....................................................................................................... 23 Structural Heart Comparisons ........................................................................ 24 4. Survey Results ? Surgery ................................................................................ 25 5. Survey Results ? Non-Clinical Compensation................................................. 27 6. Delivering High Quality, Low Cost Care: The Growing Role of .................... 28 Advanced Practice Providers and Care Teams Cardiology Tables................................................................................................ 36 Surgery Tables ..................................................................................................... 38 Non-Clinical Compensation Tables ..................................................................... 40 APP Tables........................................................................................................... 41

MEDAXIOM CARDIOVASCULAR PROVIDER COMPENSATION & PRODUCTION SURVEY ? 2015

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EXECUTIVE SUMMARY

Survey Highlights & Insights

Continuing a trend, overall

$542,000

cardiology compensation ticked

up slightly in 2014; the median

moved from $512,401 per Full Time Equivalent in 2013 to $542,000 per FTE in 2014. However, most of this gain is attributable to a significant change in subspecialty reporting mix within the private cohort.

$512,401

$29,599

INCREASE

per cardiologist

Most of this gain is attributable to a significant change in subspecialty reporting mix within the private cohort.

The result of this survey bias

caused the private physician

compensation to spike over

10 percent from a median

level of $425,897 per FTE in 2013 to $470,160 in 2014. A detailed explanation of this bias can be found in the narrative under "Survey

10,351

per cardiologist

9,862

per cardiologist

Production levels keep

falling

9,637

per cardiologist

9,538

per cardiologist

Results ? Cardiology" later

in this publication.

Overall production levels, as measured by work Relative Value Units (wRVUs), fell for the fifth straight year. Median cardiology production for 2014 now sits at 9,538 per FTE physician. In a similar trend, total imaged stress studies fell back for a fourth straight year, dropping from an annual rate of 286 per FTE in 2013 to 272 per FTE in 2014. A significant contributor to this decline was the continued erosion of nuclear SPECT volumes where the ratio of tests performed to total cognitive encounters (a strong measure of cardiology patient population) dropped from 9.0 percent in 2010 to just 7.1 percent in 2014.

In an effort to more accurately measure cardiology patient populations, MedAxiom added a patient panel measure and started collecting data for the 2013 survey. Now with a clarified definition and robust member participation, this metric will allow for more consistent testing and procedure comparisons than either the FTE or cognitive encounter denominators can yield. Beginning with the 2016 survey, relevant trending data will become available. Some specific volume measures using patient panel as the denominator can be found on page 23 of this report.

On the surgical front very little difference is noted between compensation for cardiac versus vascular surgeons, with the former measuring in at a median of $584,854 per FTE and the latter just slightly behind at a median of $570,345 per FTE--a difference of 2.5 percent. In sharp contrast, production between these two cohorts, as measured by wRVUs, differ significantly with vascular surgeons (9,085 per FTE) producing 22 percent fewer than cardiac surgeons (11,653 per FTE) in 2014.

MEDAXIOM CARDIOVASCULAR PROVIDER COMPENSATION & PRODUCTION SURVEY ? 2015

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EXECUTIVE SUMMARY

Like the findings in cardiology, surgeons in the integrated environment fare significantly better than those in private practice. For 2014 that difference was greater than 36 percent with integrated surgeons showing a median compensation level of $592,804 per FTE and private a median level of $434,546 per FTE.

Surgeons' Compensation

$592,804

$434,546

Non-Clinical Compensation Measures Also new to this publication are measures of key non-clinical

36%

compensation metrics. These find that the median level of total non-clinical compensation earned ($45,457 per FTE) is

DIFFERENCE

approaching 9 percent of median total compensation.

Further, the at-risk incentives that are put in place as part

of co-management or other physician alignment strategies are quite challenging to achieve. For 2014

PRIVATE

INTEGRATED

the median `achieved' was just 80% of the

total available in at-risk compensation.

It is by publishing these cutting-edge measures that MedAxiom hopes to continually move the needle forward for cardiovascular programs across the country.

9%

NON-CLINICAL COMPENSATION

Non-Clinical Compensation

Leadership Positions Medical Directorships Call Coverage Hospital/Health System Incentive Earned Hospital/Health System Incentive Available Non-Governmental Payor Incentives Earned Non-Governmental Payor Incentives Available

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