AMGA CFO Council: Provider Compensation Approaches to COVID-19

AMGA COVID-19 Resources

This summary is based on a discussion via AMGA’s Chief Financial Officer Council listserv as of March 18, 2020. For more information about the CFO Council, please click here.

Question: What are others doing for provider compensation (both salaried/guaranteed and productivity-based) during COVID-19 as elective procedures are cancelled, departments close, and schedules are cleared?

Mitigation Techniques to Offset Increased Cancellations, No-Shows

  • Video visits (get reliefs through waivers and collaborate with health plans on reimbursements)
  • Phone consults (if a video visit isn’t possible)

Compensation Approaches and Options
Regarding the actual compensation side, approaches vary and details are still being ironed out:

  • We are guaranteeing our providers at 90% of previous year's production for the first six months.
  • We’re protecting those on production, but haven't worked out all the mechanics on it. Most likely scenario is to use historical wRVUs per worked hour as the basis of protection (worked hours in the crisis).
  • We have not made any firm decisions on guaranteeing compensation across the board, but feel if a provider is acting in good faith to support the patients, they should be paid.
  • Still working on how to deal with physician compensation, but we are proactively focusing on giving wRVU credit to mitigate risk of reimbursement issues.
  • Contracted providers will be paid, and if they aren’t present, the impact will be recorded through paid time off (PTO).

Use of PTO Benefits
Groups are pursuing various approaches for adjusting PTO policies:

  • One independent group is currently holding firm to PTO benefit plans and requiring the use of PTO if the staff member stays at home, self-quarantines, or is potentially furloughed. Having over $1m in PTO accrual, the initial impact will be cash flow and not financial. The group may consider granting PTO to all employees after the pandemic.
  • A second group is implementing an emergency leave benefit that will pay 2 weeks of time off for an employee’s diagnosis of COVID-19, government mandated quarantine, or diagnosis of a household member. After the 2 weeks then PTO, short-term disability, or unpaid time off is to be used. Employees are allowed to go negative in their PTO by up to 40 hours.
  • Another independent group will pay any employee up to 10 days for any COVID 19-related absence, such as a positive test, quarantine, or caring for a COVID-positive family member. These 10 days will not affect their PTO balances. In addition, for any further related COVID-19 verified reason or due to childcare issues because of the closures, the group is allowing employees to go up to five days in the negative with their PTO balances.