The OIG Fraud Alert warns providers against overpaying physician in medical director positions. However, even if you have checked the payment rates on every medical director contract, you may still be paying too many medical directors.

1. 1
TOO MANY MEDICAL DIRECTORS?
DECEMBER 2015

2. Our unique opportunity
• MD Ranger collects data holistically from hospitals
and healthcare organizations; as a result, we see
spending habits and trends
• Number of positions per facility available
• Aggregated totals calculated and benchmarked
2

3. 3
The challenge:
Healthcare organizations who assign a blanket policy
for physician administrative roles without thinking about
the big picture could:
• Miss opportunities for savings
• Have a compliance problem

4. How it happens
• Negotiating individual contracts without considering
the organization’s broader goals
• Challenging physician relationships
• Not having a centralized contracting process
• No timesheet mandates; poor coordination with AP
4

5. Too much of a good thing?
5

6. It happened to these guys
-
20
40
60
80
100
120
140
160
All Hosps X 2 1 Trauma + 1 Non-Trauma1 Trauma + 1 Non-Trauma
(Urban, over 150 beds,
over 125 ADC)
Blend of All 3 with 20%
Efficiency
25% 50% 75% 90% JMH ComparisonEast Health System
Comparable MD Ranger
Subscriber (77 medical
directors)
Hemlock Health (120
medical directors)
*Pseudonym

7. 7
DIAGNOSIS:
CHECK BENCHMARKS FOR TOTAL
SPENDING

8. Number of paid administrative
positions—all MD Ranger hospitals
8
0
5
10
15
20
25
30
35
40
45
25th percentile 50th percentile 75th percentile 90th percentile
NumberofPaidPositions

9. 9
DIAGNOSIS:
REVIEW YOUR CONTRACTS IN AGGREGATE BY
SERVICE LINE AND BY PHYSICIAN

10. Prioritize by service (and know thyself)
10
$0
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
Cardiology - Heart
Center
Pathology/Clinical
Laboratory
Pediatric Surgery Trauma Surgery Vasuclar Surgery
AnnualRate
Service
Top Five Compensated Services
Median Annual Hours of Service

11. 11
DIAGNOSIS:
AUDIT ALL PHYSICIAN CONTRACTS FOR FMV
AND COMMERCIAL REASONABLENESS

12. When spending this much cash…
12
$0
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
Cardiology - Heart
Center
Pathology/Clinical
Laboratory
Pediatric Surgery Trauma Surgery Vasuclar Surgery
AnnualRate
Service
Top Five Compensated Services
Median Annual Payments

13. 13
DIAGNOSIS:
CHECK AP RECORDS AND MAKE SURE
THEY AGREE WITH PHYSICIAN TIME CARDS

14. Compliance risks lurking in hours…
14
0
100
200
300
400
500
600
Ambulatory Services Trauma Surgery Pathology/Clinical
Laboratory
Vascular Surgery Pediatric Surgery
AnnualHours
Service
Top Five Compensated Services
Median Annual Hours of Service

15. In summary:
• Check benchmarks for total spending
• Review your contracts in aggregate by service line
and by physician
• Audit all physician contracts for FMV and commercial
reasonableness
• Check AP records and make sure they agree with
physician time cards
15

16. Do you have too many medical
directors?
16
Call me: 650-692-8873
Email me: apullins@mdranger.com