Call coverage arrangements enable healthcare systems to provide vital services effectively to the communities they serve. But offering adequate coverage means having an appropriate number of physicians willing to provide their services. Determining the right arrangement for a system requires a reliance on more than just median payments or national surveys and should account for a variety of factors.
What factors should be considered in calculating call coverage payments?
In early iterations of fair market value (FMV) analysis, the burden of call coverage was largely perceived as dependent on whether the call shift required a provider to be physically on site (restricted) or if the physician could be remote during the shift (unrestricted). Over time, physicians and hospitals have clearly demonstrated that even within these two broad categories, there’s a wide variation in how significantly a physician’s lifestyle is likely to be affected during an on-call shift.
As hospitals determine FMV payments for call coverage, it is important to consider the following items in the final payment mechanism:
It is also important to gather data related to the professional fees collected by physicians as a result of these interactions in order to avoid double payment for the same services. If third-party reimbursements retained by physicians adequately compensate for all relevant burden factors, it may not be appropriate to offer any stipend.
Although this level of detail is necessary to illustrate the tangible burden of being on call, for a truly thorough analysis of the proposed arrangement it is crucial to look beyond the characteristics of a single on-call episode and consider larger system factors that may influence the overall burden.
In our final Beyond the Benchmarks post, we’ll look ahead to the future of call coverage arrangements.
If you’d like to know more now, read the full article.
Published August 29, 2013