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Getting Hospitalist Compensation Right

Karen Minich-Pourshadi, for HealthLeaders Media, February 7, 2011

Like a baseball team banking on a designated hitter, many healthcare organizations are looking to hospitalists to step up to the plate and come out swinging. As hospitalist continue to see steady increases in their compensation, hospital CFOs should assess how they compensate these players to ensure they are getting the best return on their investment.  

In the last few years, the need for hospitalists has increased exponentially in both demand and popularity. Traditional internists are trying to manage a full-time office practices in addition to rounding on patients in the hospital, and what these doctors are finding is all that leaves them little time for much else. Many of these doctors are turning to their hospitals for a solution that allows them to stay in their offices to tend to those patients. This has resulted in a split role: the outpatient internist and the inpatient hospitalist.

There's little doubt that hospital medicine physicians offer welcome relief for internists interested in staying in their offices, but how do you determine how to compensate them appropriately to ensure they will continue to generate their worth in reimbursement and in stellar patient care and quality?

Alpesh Amin, MD, MBA, professor and chairman of the department of medicine and executive director of the hospitalist program at the University of California Irvine Medical Center in Irvine, CA offers his thoughts on three areas financial leaders must consider:

1. How to Employ and Pay—Hospitals predominantly opt for direct employment versus contract scenarios. When designing a compensation structure you must consider how your competitors are structuring their plans, not just the dollars that are being offered. In general, the independent private practice tends to use a fee-for-service model while those who are hospital-employed are most inclined to receive a base salary plus incentives that reward quality, participation, and project work.

"When you contract with someone, there isn't that ownership that you get from employment," he says. "Plus, they'll do the unassigned care, sit on committees and they'll serve as leaders in your institution. I see immense amount of value with people employing their own hospitalists."

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