Administrative stipends evolving to tie in with quality metrics

MGMA recently surveyed 1,399 medical directors in 266 medical organizations to compile benchmark information reflective of compensation drivers for physician directorship activities. The resulting report, “Medical Directorship and On-Call Compensation Survey: 2012 Report Based on 2011 Data,” reveals that in many healthcare organizations physicians play an administrative role that is increasingly complex and changing in scope.

According to the report, stipend amounts for nonclinical effort continue to evolve as a component of many physicians’ total compensation plans. A directorship’s scope of responsibilities and duties impacts stipend amounts.

The report notes that primary care directorships responsible for community relations or strategic development received a higher median annualized stipend ($25,000) than their peers who were responsible for other directorship duties. Surgical specialty directors responsible for documentation and care planning, monitoring quality and appropriateness of medical care, or physician relations and/or representation reported an annualized stipend of $36,000. Nonsurgical subspecialists with provider of last resort/call availability or regulation, licensure and credentialing responsibilities earned a higher median annualized stipend ($44,586) than their peers with other duties. 

In addition, time spent on directorship activities varies greatly. The majority of survey respondents said their duties were only a component of total work time. Almost 50 percent indicated they spent fewer than six hours per week on directorship activities. As such, benchmark data reflect stipend amounts for non-clinical effort. Over time, MGMA-ACMPE staff expects the growth of the survey to allow for the depiction of compensation benchmarks for medical directors working in a predominately nonclinical capacity.

As the healthcare reimbursement paradigm changes, quality measures will become increasingly important. In light of this, the survey began asking this year’s participants to report total annualized stipend amounts by quality metrics tied to their directorships. Those in pulmonary medicine indicated an 80 percent difference in annualized stipend based on whether quality metrics were tied to their duties.

“It appears that reimbursement for medical practices will be more closely tied to quality metrics in the future, so the medical director’s most important duty will likely be that of the 'quality monitor,'” explained Jeffrey W. Smith, CPA, CGMA, MBA, CMPE, CEO, Pottstown (Pa.) Medical Specialists Inc. “As practices enhance the way they gather data through their electronic health records and practice management systems, the medical director, along with practice administrators, can review data tied to their quality metrics and be instrumental in monitoring the practice’s efforts, which could ultimately improve care and reduce costs.” 

New to this year’s report are demographic tables of medical director performance bonuses and contract information.