Some hospitals have complexities that require careful consideration while determining a physician contracting compliance process. This video will help you identify potential solutions for academic medical centers, children's hospitals, trauma centers, and small hospitals.

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Physician Contracting for Exceptional Hospitals
A MD Ranger On-Demand Webinar

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Are you an exceptional organization?
• Trauma Center
• Children’s Hospital
• Academic Medical Center
• Critical Access/Rural/Small Hospital
• Unique geography or other circumstances
• A health system with a combination of the above

3. If yes:
You are likely to have unique considerations and
challenges when it comes to physician contracting.
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4. The Challenge:
• Creating a compliant, standardized and cost efficient
FMV documentation process for physician contracts
• Finding resources and tools that address your
organization’s unique features
• Adapting resources and processes to optimize your
time, costs and documentation output throughout the
negotiation and contract approval process
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5. Suggestions for Physician Contracting at
Exceptional Organizations
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6. Trauma Centers
• Level I and II trauma centers statistically pay significantly more
for physician services so it’s important to compare your
organization to other trauma centers when determining
appropriate payments
• Not only do trauma centers pay more, but they have more paid
positions for a broader range of services
• Call coverage may be more intensive and round-the-clock
• Hospital-based services such as anesthesia may have higher demand
• Uncompensated care may be a more important factor
• Medical directorships may be managing more complex service interactions
• It is important to manage your overall contract spending
strategically and document compliance carefully
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7. Children’s hospitals
• Outsourcing contracts for pediatric intensivists, pediatric
surgery, neonatology, ROP and other pediatric sub-specialties
are important to building market share
• Benchmarks for these contracts can be hard to find
• Unique, super-star surgeons and specialists may drive high
compensation that requires strong documentation for
directorship or leadership positions
• Strong market data can also support budgeting internal funds
flow for faculty and affiliated physicians’ coverage and medical
directorships
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8. Academic Medical Centers
• Community hospital partnerships for marquis program
development and management are growing in strategic
importance
• Outsourcing contracts for highly specialized coverage such as
interventional radiology and vascular surgery can be important
to building market share – and revenue
• Strong market data can also support budgeting internal funds
flow for faculty and affiliated physicians’ coverage and medical
directorships
• Unique, super star surgeons and other recruits may drive high
compensation that requires strong documentation for
directorship or leadership positions
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9. Critical Access, Small, and Rural
Hospitals
• Providing adequate coverage for key hospital services can be a
huge challenge
• Physician expenditures can be high as a percent of total hospital
expenses, despite low ADC and bed capacity
• Benchmarking against large hospital and trauma centers can
drive costs higher than necessary for some services
• A broader range of payment benchmarks may be helpful to
address hourly rates, clinic rates, RVU-based payments, per
episode payments and uncompensated care
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10. Diverse Health Systems
• Payment policy should be consistent across the organization
which may not translate into homogenous payment rates
• Different facility characteristics often yield very different payment
expectation and payment benchmarks
• A strong benchmark product with broad scope and rates for
differing facility characteristics allows consistent benchmarking
• Identification of outlier facilities and opportunities for savings
support is a plus
• Multi-facility contracts and appropriate adjustments for rates
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Physician Contracting Compliance for
Everyone

12. All contracting programs should have
these elements:
• Executive oversight
• Strategic and tactical contract management
• Financial management
• Compliance management
• Rigorous FMV determination and documentation
process
• Routine internal audit process
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13. Create a standardized process that is
simple and effective
• Designate an executive to oversee the process
• Automate as much as possible
• Ensure that analysis of contract expenditures is done
annually, if not more frequently
• Determine a rigorous and straightforward way to
document FMV consistently
• Define a process to address exceptions to your internal
benchmark standards
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14. Determine and document FMV with
market data
• High-quality market data is the fastest, most
straightforward way to determine and document
physician payments
• Test for commercial reasonableness
• Determine if there’s a match in scope of services
• Find the appropriate market range and determine
payment
• Document FMV
• Internal review and sign-off
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15. Seek outside help when needed
• If there is no comparable market data or the position
demands particular qualifications with exceptional
pay, consider getting a valuation.
• If you must pay above the 75th percentile, make sure
documentation is solid.
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16. If you need a comprehensive physician
contracting program that works for
your unique organization…
We can help!
MD Ranger, Inc.
650-692-8873
inquiries@mdranger.com
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