The highlight of SHM’s biennial State of Hospital Medicine (SOHM) report is how much hospitalists earn. So it’s to be expected that rank-and-file practitioners and group leaders who read this year’s edition will first notice that median compensation for adult hospitalists rose 8% to $252,996 in 2013, according to data from the Medical Group Management Association (MGMA). The compensation data from MGMA is wrapped into the SOHM 2014 report this year.
But to stop there would be a wasted opportunity, says William “Tex” Landis, MD, FHM, medical director of Wellspan Hospitalists in York, Pa., and a member and former chair of SHM’s Practice Analysis Committee. Along with compensation, the report (available at www.hospitalmedicine.org/survey) delves into scheduling, productivity, staffing, how compensation is broken down, practice models, and dozens of other topics that hospital medicine group (HMG) leaders will find useful.
“Scope of services is a big one,” Dr. Landis adds. “What other things are hospital medicine groups around the country being held responsible for? Are we morphing into universal admitters? How involved in palliative care are we? What about transitions of care? How many hospital medicine groups are becoming involved in managing nursing home patients? What’s the relationship with surgical co-management? How much ICU work are we doing?”
Dr. Landis’ laundry list of unanswered questions might seem daunting, but that’s the point of the research SHM has been collecting and reporting for years. The society surveyed 499 groups, representing some 6,300 providers, to give the specialty’s most detailed list of most popular, if not best, practices.
“It has the usual limitations of any survey; however, it is the very best survey, quantity and quality, of hospital medicine groups,” Dr. Landis says. “And so it becomes the best source of information to make important decisions about resourcing and operating hospital medicine groups.”
And, like it or not, compensation for providers typically is a HMG’s largest budget line. In that regard, the specialty appears to be doing well. Median compensation for adult hospitalists rose to a record high last year, according to the MGMA Physician Compensation and Production Survey: 2014 Report Based on 2013 Data. Half of respondents work in practices owned by hospitals/integrated delivery systems, down from 56% in SOHM 2012.
Although hospitalists in the South region continue to earn the most (median compensation $258,020, essentially static with the $258,793 figure reported in 2012), the region was the only one to report a decrease (see Table 1 for historical data). The largest percentage jump (11.8%) was for hospitalists in the West region ($249,894). Hospitalists in the Midwest saw a 10% increase ($261,868), while those in the East had both the smallest increase (4.8%) and the lowest median compensation ($238,676).
It will be interesting to see what the data shows over the next three or four years if stipends, as we believe we are seeing, come under pressure and hospitals are doing more outsourcing.
—R. Jeffrey Taylor, president and COO, IPC The Hospitalist Co., North Hollywood, Calif.
Part of the compensation increase is tied to upward pressure on productivity. Nationwide, median relative value units (RVUs) rose 3.3%, to 4,297 from 4,159. Median collection-to-work RVUs ticked up 6.8%, to 51.5 from 48.21 (see Table 2 for regional breakdowns). Production (10.5%) and performance (6.6%) are also slightly larger portions of mean compensation than they were in 2012, a figure many expect to increase further in future reports. The report also noted that academic/university hospitalists receive more in base pay, while hospitalists in private practice receive less.
Compensation and work volume will be intrinsically tied in the coming years, says R. Jeffrey Taylor, president and chief operating officer of IPC The Hospitalist Co., based in North Hollywood, Calif. And if pay outpaces productivity, “then it’s a bit concerning for the system at large,” he says.