MDNews - Central New York

++++++++++++++++++++++++++++++ + +++ +PRACTICE MANAGEMENT U +++ ++++++++++++++++++++++++++++++ Beyond the Fine Print: Navigating Physician Hospital Employment Contracts DECIPHERING THE COMPLEXITIES AND CONTRACTUAL LANGUAGE OF A HOSPITAL EMPLOYMENT CONTRACT CAN BE CHALLENGING BUT CRITICAL TO A PHYSICIAN'S FUTURE. W ITH REIMBURSEMENT RATES evolving and the cost of maintaining a private practice skyrocketing, many physicians are looking to align themselves with larger health care systems or community-based hospitals. As a result, hospital preliminary employment contracts are now par for the course when it comes to physicians securing permanent employment. At first glance, an employment agreement might seem a straightforward outline of necessary provisions such as benefits, compensation and professional duties. However, such contracts become overwhelmingly complex with the addition of unique content not found in other workplace agreements, as hospitals attempt to define intricate termination clauses, noncompete agreements, restrictive covenants, insurance matters, and compliance with federal and state laws or guidelines. Word for Word "Physicians entering into new employment agreements need to have a clear understanding of the compensation arrangement and how the agreement might restrict their freedom to make professional moves in the future," explains Dan Glessner, an attorney certified in health care compliance law by the Health Care Compliance Association, partner with Brouse McDowell and Chair of the Health Care Practice Group. "Making an informed decision on whether or not to accept a hospital's offer can save a physician a tremendous amount of 'buyer's remorse' down the road. It is very important that all expectations are on the table before the agreement is executed." 8 | Central New York MD NEWS I MDNEWS.COM According to Glessner, more and more employment agreements are moving away from guaranteed salary arrangements and following newer models that enable the hospital to meet emerging reimbursement trends. "Many hospitals are tying compensation to productivity and are using relative value units [RVUs] related to a physician's work or collections to measure a physician's productivity and determine their compensation," says Glessner. "Simply put, physicians are being required to assume more of the risk of uncertain changes to reimbursement. For example, the value of a work RVU may be decreased by Medicare or reimbursement rates from private insurers may be decreased, impacting a physician compensation model based on collections." Is Everybody Happy? Another evolving element related to compensation arrangements involves having a physician's income tied partly to patient outcomes and other quality measures of care, such as patient satisfaction surveys and readmittance rates. "Medicare is now tying patient quality data to hospital payments," Glessner notes. "While such quality-based incentives may be intended to reward physicians for the quality provision of patient care, these programs only work if the guidelines are not ambiguous. The quality measurements must be spelled out on the front-end of a hospital employment contract so a physician knows exactly how such compensation or incentive bonuses will or will not be paid." Are you struggling to understand the intricacies of physician hospital employment contracts? Post your questions to our Facebook page or via Twitter using the hashtag #MDNemployment, and we'll answer them in an upcoming iPad edition of MD News. I

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