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by Chris Burns, President, EA Health

Hospitals and health systems approach us all the time looking for creative solutions to alleviate their call compensation woes. Even though most of them are paying daily stipends to their specialists, they still struggle to fill and maintain their ER call panels. It’s become increasingly clear to them that stipends alone aren’t the answer.

For physicians, taking call is no longer seen as an effective way to build a medical practice. And when the hospital’s payer mix is viewed by most of them as more risk than reward, it’s no surprise that hospitals are having trouble attracting high-quality specialists to support their emergency departments.

Our hospital and health system clients have found that adding an intelligently designed and well-managed fee-for-service component to their daily stipend programs has provided the extra incentive most specialists need to actively participate in and support their ER call panels. Here’s what two different health system executives had to say recently about EA Health’s blended call compensation solution:

5-Hospital Health System in Texas

Were your stipend rates rising before installing EA Health’s stipend plus fee-for-service program?

Yes, demand for higher call stipend rates had gotten to the point where some specialties refused to even take call.

How has EA Health’s blended call compensation solution improved specialty call coverage?

Our EA Program has solved the problem caused by varying levels of unfunded patients at our different hospitals. Some of our locations have limited call activity and few unfunded patients, so on-call physicians there receive only a stipend to cover call. At our hospitals with a higher number of unfunded patients, call panel physicians are additionally compensated via the FFS payment for seeing these patients. As unfunded patient volume increases, the FFS payments automatically increase as well. Our on-call physicians don’t feel as though they are being taken advantage of or losing out because they’re being fairly compensated for the extra workload. This in turn lessens the demand for a higher stipend payment to cover these costs.

What is your call coverage situation like today?

The core specialties are covered very well now. Since compensation is correlated to the physicians’ workload, they are definitely happier than with a straight stipend model. The FFS option has also helped us a great deal in providing our hospitalists the consult coverage they need from sub-specialists. We don’t have to provide a daily stipend in these situations; generally the consulting specialist just wants the protection that they will be fairly compensated for the care they provide to any unfunded patients.

4-Hospital Health System in Southern California

What was your ER call coverage like before implementing your EA Health fee-for-service program?

Prior to our partnership with EA Health, our health system didn’t have a comprehensive way to understand the true scale of our ER coverage issues and individual coverage gaps. We were looking for a way to address call coverage with a unified approach consistent with our vision and long-term strategic needs.

How has EA Health’s call compensation program improved specialty call coverage?

EA Health has provided the unifying vehicle to address coverage gaps at both the site and system level. Their program provides not just the financial model to solve our coverage issues, but they take it a step further by supplying the analytical reporting to justify the investment and identify new opportunities for improved coverage models. EA Health provides us with proprietary info as well as regional and national benchmarking data to understand where our solution fits within our local and regional markets for similar services.

What is your call coverage situation like today?

Although we still face occasional coverage challenges in certain subspecialties in some markets in which we operate, these challenges are much less volatile than they used to be. Our EA program is the primary call compensation solution we offer to our specialists within a portfolio of solutions we now have at our disposal. In the true spirit of partnership, EA Health collaborates with us to utilize existing programs and also develop new and innovative solutions to deal with any future coverage problems we may encounter.

Conclusion

EA Health’s blended call compensation program is a financially sensible long-term solution that benefits both hospitals and physicians by shifting the emphasis from fixed-rate only to a variable reimbursement model. While the stipend addresses the inconvenience of being on call, the fee-for-service payment compensates the on-call specialist for the actual services they provide. Our clients have consistently found that adding a FFS component to their stipend program encourages increased specialist support of their emergency department call panels.

break the stipend cycle

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