Hospitalist productivity improves with lower base salary, report indicates

A lower base salary means increased productivity and higher overall compensation for hospitalist physicians, according to a new report.

A survey by the Medical Group Management Association and the Society of Hospital Medicine reveals that adult hospitalists who received 50 percent or less of their compensation as fixed base salary reported the highest median work relative value units (wRVUs) at 5,407, compared to colleagues.

Work RVUs refers to the 'work' component of the relative value unit system published by Medicare.

The "State of Hospital Medicine: 2010 Report Based on 2009 Data" shows that hospitalists who received 51 percent to 70 percent of their compensation as base salary performed 4,591 wRVUs, compared to 3,859 wRVUs for hospitalists who received 71 percent to 90 percent of their compensation as base salary.

Individuals who received 91 percent to 100 percent of their compensation as base salary reported 3,571 wRVUs.

The report contains information on 443 hospital medicine groups and 4,211 hospitalists. It's the first joint effort between the MGMA and SHM in collecting data on hospital medicine groups, and replaces SHM's independent biannual survey, which was last published for 2007-2008.

The 2010 report also includes group-level data on compensation methodology, group size and staffing mix, turnover and growth, staffing models and night coverage models.

"The compensation methodology (for hospitalists) has evolved from a straight base salary to base salary plus incentive, based on production and quality metrics," said Jeffrey B. Milburn of the MGMA's healtcare consulting group.

The reported median wRVUs are higher for physicians in practices that are not hospital-owned than for physicians in hospital-owned practices, and physicians working in practices that provide on-call coverage at night generated more wRVUs than physicians working in practices that provide on-site care at night.

Internal medicine hospitalists reported median compensation of $215,000. Family practice hospitalists received $218,066 and pediatric hospitalists reported compensation of $160,038. The report also indicates compensation varies based on geographic location, practice teaching status and practice size.

"This new data will prove tremendously helpful to hospitalists and healthcare executives alike," said William "Tex" Landis, MD, chairman of SHM's practice analysis committee. "While it is important to keep in mind that wRVUs cannot measure every work effort, this survey data will definitely support better decisions about how hospitalist practices are resourced, and it will ultimately promote delivering the best possible care to hospitalized patients across the country."