Managed Healthcare Executive - November 2008 - (Page 30)

Surgical specialties post increases THE AMERICAN MEDICAL GROUP Assn.’s 2008 Medical Group Compensation and Financial Survey is not painting an especially lucrative picture for surgical specialties, whose compensation rose an average of 3.7% in 2007, compared with an increase of 6% in 2006. Cardiac and thoracic surgery, however, jumped 8.11%, more than most surgical and medical specialties, while compensation for urology surgery rose 4.65%, the second-highest increase. Other surgical specialties’ compensation rose less, with emergency medicine, otolaryngology and general surgery bringing up the rear with 0.53%, 2.67% and 2.96% compensation increases, respectively. Brad Vaudrey, director of the healthcare consulting practice for RSM McGladrey Inc. in Minneapolis, which conducted the survey, says that o cebased medical specialties —dermatology (8.97%) and medical oncology (7.66%)—earned the largest percentage jumps in compensation between 2006 and 2007, while surgical specialties were nearly at. He attributes the small increase to the changes in the relative value units (RVUs), made by the Centers for Medicare & Medicaid Services (CMS) in 2007, and to a decrease in the overall pool of available dollars for distribution to providers. The uctuations in RVUs made it di cult to create compensation conversion rates, Vaudrey says. However, he is optimistic that as RVUs stabilize, compensation will continue to follow the earlier trend. Faye Gargiulo, vice president of physician and service-line development for a multi-specialty practice in Southeast 30 NOVEMBER 2008 MEDIAN GROSS CHARGES 2004-2007 Surgical Specialties Cardiac & Thoracic Surgery Emergency Medicine General Surgery OB/GYN - General Ophthalmology Orthopedic Surgery Otolaryngology Urology 2004 $1,505,710 $711,663 $1,193,418 $967,367 $1,319,542 $1,511,748 $1,199,437 $1,417,510 2005 $1,875,143 $784,688 $1,270,049 $1,023,106 $1,430,224 $1,702,524 $1,368,637 $1,610,700 2006 $1,872,880 $770,185 $1,293,245 $1,071,669 $1,484,257 $1,778,351 $1,372,031 $1,724,219 2007 $2,171,922 $817,678 $1,356,302 $1,102,417 $1,534,600 $1,815,525 $1,406,763 $1,793,582 Source: American Medical Group Assn. Virginia, Riverside Medical Group, also puts her money on procedural-based specialties, for which she has seen a disproportionate rate of growth in compensation. “The irony is surgical specialties’ livelihoods depend on medical specialties that refer their patients,” she says. “Unfortunately, since there is not much incentive to encourage practicing primary care, the shortage is a ecting surgeons.” Vaudrey anticipates that as the population ages, compensation for orthopedic surgery will increase, along with subspecialties that prove pro table. GROSS CHARGES The survey also measured median gross charges—a measure of a physician’s productivity. Again cardiac and thoracic surgery increased the most among the surgical disciplines (15.97%), ahead of emergency medicine (6.17%), general surgery (4.88%) and urology (4.02%), with orthopedic surgery lagging furthest behind at 2.09%. Comparing longer-term trends, cardiac and thoracic surgeons saw a 44.25% increase from 2004 to 2007—again, the highest increase—and it was the general surgeons who saw the least increase over the time period, with median gross charges increasing 13.65%. PROFESSIONAL VALUE Even though emergency medicine Median work RVUs, which represent surgical specialists show the lowest methe professional value of services pro- dian gross charges for 2007 by dollar vided by a physician, matched com- amount, their percent change since 2006 pensation in most cases except for of 6.17% was second only to cardiac and emergency medicine, which jumped thoracic surgeons. 22.22% between the two years. In the Comparing dollar amount changes surgery mix, cardiac and thoracic sur- over the four-year period shows a leadgery led the pack with 33.32% because ing uptick of $666,212 for cardiac and of a high rate of coronary bypasses and thoracic specialists, while emergencyto 2007 RVU changes, Vaudrey says, medicine specialists charged $106,015 followed by urology (13.62%) and ob/ more, the lowest increase. MHE gyn (10.66%), attributed to their o ce—Mari Edlin based procedures. Commentary is independent of source data

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Managed Healthcare Executive - November 2008 For Your Benefit Editorial Advisors Contents News Analysis State Report Politics &�Policy Letter of the Law Affordable Access Economic Ripple Effect Hospitals &�Providers Technology Managed Care Outlook Desktop Resource Ad/Edit Index

Managed Healthcare Executive - November 2008

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