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  • Compensation

  • What ID Physicians Are Paid

  • ID Physician Compensation Data from IDSA, MGMA, and AMGA (2004-2015)
    On the recommendation of the Clinical Affairs Committee and with the approval of the Board of Directors, IDSA fielded a survey to all US members aimed at assessing compensation across the specialty.  The survey was completed by almost 1900 respondents and the results can be found here: Infectious Diseases Physician Compensation Assessment (PDF) The results of this survey were discussed in Open Forum Infectious Diseases in April 2016.

     

    2015 ID Physician Compensation Data

    A PDF of the above graph can be viewed here.
     
    According to the MGMA On-Call Survey: 2014 Report Based on 2013 Data — Key Findings Summary Report, 85.20% of on-call nonsurgical subspecialists are compensated by daily stipend. Additionally, the on-call provider daily rate for nonsurgical subspecialists was reported to be $900 (76 or more respondents), $813 (26-75 respondents), and $755 (25 or fewer respondents). Please view the MGMA On-Call Survey: 2014 Report Based on 2013 Data — Key Findings Summary Report (PDF) for more details.
    ID Physician Compensation and Gross Charges (2004-2015)

    The following compensation and gross charges data from the Medical Group Management Association (MGMA) is provided as service to our members.

    To view the data in the form of a table, please click HERE.

    To view Medicare Utilization Data for Infectious Diseases Specialists, please click HERE.

    2015 MGMA ID Physician Total Compensation  

     

    2015 MGMA ID Physician Gross Charges

    Due to contractual restrictions, displaying the exact compensation and gross charge figures regarding the ID specialty is not permissible. Please inquire IDSA staff for more information on compensation and gross charge figures.
     

    Source: MGMA DataDive™ Provider Compensation 2004-2014.  Used with permission from MGMA, 104 Inverness Terrace East, Englewood, Colorado 80112.  877.275.6462.  www.mgma.com.  Copyright 2015. 


     

    ID Physician Compensation to RVUs (2008-2015)

    2015 MGMA ID Physician Compensation to wRVU

    Physician Work RVUs Include:
    1) RVUs for the "physician work RVUs" only, including adjustments made as a result of modifier usages;
    2) Physician work RVUs for all professional medical and surgical services performed by providers;
    3) Physician work RVUs for the professional component of laboratory, radiology, medical diagnostic, and surgical procedures;
    4) Physician work RVUs for all procedures performed by the medical practice. For procedures with either no listed CPT code or with an RVU value of zero, RVUs can be estimated by dividing the total gross charges for the unlisted or unvalued procedures by the practice’s known average charge per RVU for all procedures that are listed and valued;
    5) Physician work RVUs for procedures for both fee-for-service and capitation patients;
    6) Physician work RVUs for all payers, not just Medicare;
    7) Physician work RVUs for purchased procedures from external providers on behalf of the practice’s fee-for-service patients;
    8) Anesthesia practices should provide the physician work component of the RVU for flat fee procedures only such as lines, blocks, critical care visits, intubations, and post-operative management care; and
    9) All RVUs associated with professional charges, including both medically necessary and cosmetic RVUs; and
    10) RVUs attributed to the Physician Fee Schedule.

    Appendix F: Compensation and Production Survey: 2012 Guide to the Questionnaire Based on 2012 Data, ©2013 MGMA

     

    2015 MGMA ID Physician Compensation to Total RVUs Ratio

     

    Total RVUs Include:
    1) RVUs for the “physician work RVUs”, “ practice expense”, and “malpractice RVUs” including any adjustments made as a result of modifier usage;
    2) RVUs for all professional medical and surgical services performed by physicians, nonphysician providers, and other physician extenders such as nurses and medical assistants;
    3) RVUs for the professional component of laboratory, radiology, medical diagnostic, and surgical procedures;
    4) For procedures with either no listed CPT code or with an RVU value of zero, RVUs can be estimated by dividing the total gross charges for the unlisted or unvalued procedures by the practice’s known average charge per RVU for all procedures that are listed and valued;
    5) RVUs for procedures for both fee-for-service and capitation patients; and
    6) RVUs for all payers, not just Medicare; and
    7) RVUs attributed to the Physician Fee Schedule.

    Appendix F: Compensation and Production Survey: 2012 Guide to the Questionnaire Based on 2012 Data, ©2013 MGMA

    Source: MGMA DataDive™ Provider Compensation 2004-2014.  Used with permission from MGMA, 104 Inverness Terrace East, Englewood, Colorado 80112.  877.275.6462.  www.mgma.com.  Copyright 2015.

     

    Compensation for Antimicrobial Stewardship and Infection Control

    MD Ranger: Compensation for Administrative Antibiotic Stewardship Services
    MD Ranger is a company that provides benchmarks and analysis on physician contracts; its proprietary database provides information on the specific terms of agreements between health facilities and physicians for emergency call coverage, medical direction and other leadership positions. This report lists payment for administrative antibiotic stewardship services. For reports from MD Ranger, "P" stands for "providers" and refers to the number of health care systems on which the report is based; "F" stands for "facilities" and refers to the number of hospital facilities. Therefore, some figures may represent data from several facilities within the same health care system.

    MD Ranger: Compensation for Administrative Infection Control Services
    This report from MD Ranger lists compensation figures for Infection Control Medical Direction. This report lists an average hourly compensation rate of $160 (median = $150) which is very similar to what we are able to confirm within the MGMA database (due to licensing issues we are not able to disclose the MGMA figures). MD Ranger shows the 90th percentile as $190 which is significantly lower (~20% lower) than what MGMA reports.

  • Negotiation Skills Resources

  • Articles on the Value of ID Physicians
    CID: Infectious Diseases Specialty Intervention is Associated with Decreased Mortality and Lower Healthcare Costs

    Summarizes the versatile attributes possessed by ID specialists and delineates their value to patients, hospitals, and other integral groups in the health care continuum.

    Gain-sharing & Co-Management

    ID-focused Hospital Efficiency Improvement Program
    This guide describes how to implement services aimed at mitigating healthcare-associated infections and other infectious disease-related issues under the leadership of an ID physician executive. It provides clear descriptions of activities (services lines) and metrics for the following services lines: Infection Prevention & Control; Antimicrobial Stewardship; Outpatient Parenteral Antimicrobial Therapy Hospital Admission/Readmission Avoidance; and Bio-security, Bio-preparedness, & Emerging Infectious Diseases.

    IDSA Guide to Co-Management Agreements for Antimicrobial Stewardship, Infection Control & Prevention Services - July 2014 (PDF)
    This guide provides background, rationale, and sample contract language to assist IDSA members who are interested in co-management agreements with a hospital or healthcare system.

    VMG Health Market Study of Infectious Disease Physician Executive Compensation - November 2013 (PDF)
    This market study reviews the infectious diseases physician executive hourly rate for administrative or clinical management services provided in the infectious disease service line.

    VMG Health Market Study of Infectious Disease Incentive Compensation for Achievement of Quality Outcomes Measures - June 2014 (PDF)
    This market study reviews the maximum annual incentive compensation for the infectious diseases specialty payable by hospitals for services rendered in the infectious disease service line.

    Legality of Gain-sharing Arrangements Between Infectious Diseases Physicians and Hospitals (PDF) 
    Memorandum that provides information concerning gain-sharing arrangements between hospitals and physicians, the history of the growing acceptance of gain-sharing with the Center for Medicare and Medicaid Services (CMS) and the Office of the Inspector General (OIG), factors that OIG and CMS consider in approving gain-sharing arrangements, and recommended process for Infectious Diseases clinicians to approach such arrangements.

    Gain-sharing Contract Template 
    Template for an agreement for infection prevention/epidemiology services.

    The ID Service Line
    Co-management agreements are typically used for specific hospital service lines, such as cardiology and orthopedics. This article provides guidance on how the concept for how Infectious Diseases services can be considered as a hospital service line. This article appeared in the July/August 2015 issue of Physician Leadership Journal, which is a publication of American Association of Physician Leadership.

    Value of ID Specialists Manuscript Resources

    The Value of Infectious Diseases Specialists Brochure (PDF) - IDSA Branded
    The Value of Infectious Diseases Specialists Brochure (PDF) - Unbranded

    NOTE: IDSA members may download and print - at members' own expense - The Value of Infectious Diseases Specialists Brochure for distribution to interested parties. The unbranded version of The Value of Infectious Diseases Specialists Brochure may be customized and printed with members' respective contact information and/or affiliated logos before distribution.

    ONLY THE ADDITION OF IDSA MEMBER'S CONTACT INFORMATION AND/OR AFFILIATED LOGOS IS PERMISSIBLE. THE CONTENT AND APPEARANCE OF THE VALUE OF INFECTIOUS DISEASES SPECIALISTS BROCHURE CANNOT BE ALTERED.

    The Value of ID Specialists Presentations (.zip)
    The Value of Infectious Diseases Specialists presentation provides a high-level review of the evidence implicating the beneficial impact of ID intervention on patient outcomes as well as the objective, methods, and limitations of the study published in Clinical Infectious Diseases.

    Presentations available in PowerPoint with speaker notes, PDF with speaker notes, and PDF formats.

    Instructions on How to Issue a Press Release (PDF)
    Provided is step-by-step instructions on how to fill out the Press Release Template (below) and inform your local media outlets on the publication of the "Infectious Diseases Specialty Intervention is Associated with Decreased Mortality and Lower Healthcare Costs" manuscript.

    Press Release Template (PDF)
    The customizable Press Release Template summarizes the beneficial impact Infectious Diseases Specialists have on patient outcomes expressed in the "Infectious Diseases Specialty Intervention is Associated with Decreased Mortality and Lower Healthcare Costs" manuscript. Please fill out the template according to the Instructions on How to Issue a Press Release document linked above.

    Value of ID Specialists: Delivering the Message

    See examples of how IDSA members are presenting the Value of ID Specialists messages to important stakeholders below.

    The Critical Value of Infectious Disease Specialists (Video) 
    Steven Schmitt, MD, FIDSA, FACP
    Vice Chair, Medicine Institute
    Cleveland Clinic
    Dr. Steven Schmitt discusses and highlights the importance of infectious diseases specialists within a healthcare system that is moving towards value-based, team care. The PowerPoint presentation is also available for download (PPT).

    Infectious Disease Strategies to Limit Hospitalization and Reduce Risk (Video) 
    Ronald Nahass, MD, MHCM, FIDSA
    President, ID CARE
    Clinical Professor of Medicine, Rutgers
    University Robert Wood Johnson Medical School

    Dr. Nahass discusses the value and services of infectious diseases specialists that can help limit unnecessary admission, readmissions, and avoidable complications. The PowerPoint presentation is also available for download (PPT).

    Infectious Disease in an Era of Health Care Transformation
    Hospitals & Health Networks Daily makes available a short video interviewing Dr. Steven Schmitt, who provides brief rationale as to why infectious disease specialists are the most qualified physicians to lead antibiotic stewardship programs at a hospital or health system. 

  • FMV Resources

  • FMV Resources and Reimbursements for ID Medical Directors

    Infectious diseases (ID) physicians serving as infection prevention or antimicrobial stewardship medical directors must receive reimbursements that are consistent with the fair market value (FMV) of their services. As defined by the physician self-referral law ("Stark") law, fair market value is "the value in arms length transactions, consistent with the general market value" of your services. This means that ID physicians in consultation with their hospitals are free to establish reimbursement levels that are consistent with the market value of their services in a given area. This document provides an overview of FMV, Stark law, and other terms seen in contracting for physician services.

     

    IDSA has long argued that, at a minimum, ID medical directors' reimbursements should account for the overhead costs required to maintain their practice. The following is an example of a reimbursement formula that can be used as a starting point in negotiations with your hospitals:

    FMV =

    Median Gross Charges
    (or Collections) per Year


    2000 Hours


    ID physicians' gross charges and compensation data is published annually by the Medical Group Management Association (MGMA). While some ID practices question the accuracy of MGMA data, it is one of the few sources of such data and is well understood by hospital administrators.

    The MGMA Medical Directorship Compensation Survey: 2014 Report Based on 2013 Data — Key Findings Summary Report found that the total annualized compensation for nonsurgical subspecialists was $31,500 for hourly rate and $21,336 for monthly stipend. Findings regarding quality metrics tied to directorship as well as hours spent on directorship duties and number of responsibilities can be reviewed in the MGMA Medical Directorship Compensation Survey: 2014 Report Based on 2013 Data — Key Findings Summary Report (PDF).

    Negotiating Strategies to Maximize Your Reimbursements

    Once a reimbursement formula and a data source have been identified, it is up to the individual ID physician to make the case for his/her value. Cultivating relationships with your hospital administrators based on trust, mutual respect, and proven results are the best way to ensure that your infection control reimbursements are commensurate with your value. It also is helpful to remember a few negotiating strategies that have been successfully used by your colleagues.

    In October 2008, The Value of Infectious Diseases Specialists: Non-Patient Care Activities was published in Clinical Infectious Diseases (CID). The article provides a compendium of data sources that ID specialists can use in demonstrating their value to hospital administrators during contract negotiations. 

    Finally, a presentation on how to negotiate infection control contracts were given at the 2009 Clinical Practice Meeting. The presentation was presented as a point-counterpoint from a physician's standpoint

    Fair Market Value Safe Harbors: Fact or Fiction

    Fiction. Hospitals often cite two "voluntary" reimbursement methodologies that the Department of Health and Human Services (HHS) deemed as safe harbors for the purpose of meeting fair market value. HHS' withdrew these reimbursement methodologies as safe harbors in August 2007 largely due to a lawsuit filed by the Renal Physicians' Association and supported by the IDSA and several other medical specialty societies.

    Below are the withdrawn safe harbor methodologies for calculating fair market value hourly payment rates for physicians serving as medical directors:

    Methodology 1

    The hourly payment for a medical director cannot exceed the average hourly rate for emergency room physician services in the relevant physician market, provided there are at least three hospitals providing emergency room services in the market.

    Methodology 2

    The hourly payment for a medical director is calculated by averaging the 50th percentile salary for the physician's specialty of four national salary surveys and dividing the resulting figure by 2000 hours to establish an hourly rate. The CMS rule provides a choice of six recognized, readily available surveys.


    Hospitals often used these payment methodologies as a justification to reduce the payments for the services of infection control medical directors by as much as 50 percent (e.g., from $150 per hour to $85-95 per hour). Be wary of hospitals that continue to cite these withdrawn safe harbors in an effort to limit your reimbursements.

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