Thanks to an ongoing physician shortage, compensation for cardiologists has been ample in recent years. Could the healthcare industry’s growing interest in value over volume lead to a change in that trend?
Specialists from a variety of backgrounds took up the question during a presentation at Cardiovascular Summit Virtual, an online conference hosted by the American College of Cardiology.
Taking on more risk can lead to improved compensation
Suzette Jaskie, MBA, vice president of the cardiovascular service line at Ascension Wisconsin, noted that the future of cardiologist compensation will likely be determined by a variety of factors, including workforce dynamics, healthcare reform and the role of invasive procedures going forward. Perhaps the most important factor of all, though, is risk.
Some health systems, Jaskie explained, are expected to keep shouldering the risk and paying physicians based on productivity. Physician performance will make a minimal impact on these instances and lower compensation will be moderated by supply and demand.
In other compensation models, however, physicians will take on more risk. This means they are less likely to be paid based on productivity—though that is likely to still play some sort of role—and more likely to be paid based on their ability to provide patients with high-quality care. In these instances, higher compensation would be moderated by supply and demand.
In these value-based models, Jaskie said, overall cardiologist compensation “has the potential to be higher.”
A spotlight on leadership
William T. Katsiyiannis, MD, president and chair of cardiology at the Minneapolis Heart Institute, explored the impact leadership and culture can have on compensation models in cardiology.
The current push for value over volume is what many cardiologists and other specialists have wanted for a long time now, Katsiyiannis observed. But cardiologists have to take advantage of this moment, or they risk wasting the opportunity altogether and regretting the change.
“You have to have the right team and the right culture,” he said. “And when I say ‘team,’ there are multiple components to that term. To use a football analogy, that means the players, the coaches and the owners.”
Katsiyiannis also spoke to the challenges that go hand in hand with changing your organization’s compensation model. What’s the distribution plan? How can we get everyone on board with new incentives and policies?
As leaders, it’s important to gain everyone’s trust and think through each and every decision. Managing all these things at once, Katsiyiannis said, “will take cultural leadership.”
‘The relationship between wRVUs and compensation is going to change’
Joshua Halverson, a principal at ECG Management Consultants, looked at the future of cardiologist compensation from the point of view of an evaluator.
Looking at the fair market value of a specialist, he said, is about balancing “a set of individual facts and circumstances.” Production, training, experience, supply and demand, a program’s scope and size, administrative responsibilities all come into play.
Halverson also explained how the COVID-19 pandemic and updated Medicare policies have changed the way evaluators do their jobs. Survey data has long been used to determine fair market value, for example, but future survey data could be “problematic” because of these massive changes to the U.S. healthcare system.
“Many organizations utilize multi-year blends or multi-survey blends to establish a conversion factor,” Halverson said. “Going forward, looking at survey data and how surveys are or aren’t adjusted is going to be critical when establishing a conversion factor that is fair and reasonable. The relationship between wRVUs and compensation is going to change.”
Overall, though, it appears clear to Halverson and his colleagues that the shift toward value-based care is coming to cardiology.
“Firms like ours are really working right now on developing more sophisticated thinking around the tangible value created by physicians who are pursuing value-based activities,” he said, noting that this is likely to be a huge game-changer for cardiologist and cardiology practices alike.
None of the session’s participants had any disclosure to share.
More information on Cardiovascular Summit Virtual is available here. Attendees can access numerous pre-recorded sessions, including the one discussed in this article, with the click of a mouse.