Medicare risk adjustor practitioner pay?

[SoCal_PA]

I am interviewing for a job that requires PA or NPs to go to clinics and conduct a detailed history, physical, and chart review in order to uncover diagnoses that have been undiagnosed in order to adjust the patient's risk factor and Medicare payment. Anyone heard of this? It will be with a very large corporation. 

All I have found online are "medicare risk adjustors" who are not medical practitioners. 

Anyone know what to expect as far as compensation? I have no reference point

 

Thanks!

[sas5814]

I know a physician who sold his clinic and practice to a large organization and then stayed in the same clinic. They converted it and him to doing annual Medicare wellness visits which sounds similar to what you are describing. It is not about treating or following existing problems so much as a deep evaluation of history and a physical to find and identify everything that is wrong with the patient especially things that were previously undiagnosed. He saw an average of 8 to 10 daily 3 days a week and was making about 200k with all the overhead borne by the organization.

I don't know if that is relevant to what you are interviewing for but it might at least give you some reference point.

[SoCal_PA]

4 minutes ago, sas5814 said:

I know a physician who sold his clinic and practice to a large organization and then stayed in the same clinic. They converted it and him to doing annual Medicare wellness visits which sounds similar to what you are describing. It is not about treating or following existing problems so much as a deep evaluation of history and a physical to find and identify everything that is wrong with the patient especially things that were previously undiagnosed. He saw an average of 8 to 10 daily 3 days a week and was making about 200k with all the overhead borne by the organization.

I don't know if that is relevant to what you are interviewing for but it might at least give you some reference point.

Great information, thank you. This is exactly what was told to me. I would be seeing 10-12 patients/day, 3 days a week and then 2 days would be at home or office doing chart reviews. 

 

Any idea what I should ask for in terms of pay if an MD is getting $200k?

[sas5814]

I couldn't even begin to guess because there is so much variation in pay by region. Just remember it is always easier to ask for too much and negotiate down. You can never negotiate up. 

[SoCal_PA]

2 minutes ago, sas5814 said:

I couldn't even begin to guess because there is so much variation in pay by region. Just remember it is always easier to ask for too much and negotiate down. You can never negotiate up. 

I live in southern CA (cost of living is $$$). The average across all specialties is about $110k/yr. 

I am currently making $65/hr as an ER PA. 

Would $75/hr come off as offending? The recruiter who is part of this company said the base they have listed is $60/hr which I would not accept. 

[sas5814]

No that isn't offending but I'd be prepared for them acting like you asked for a private jet. It is all part of the game. I work in Texas where the cost of living is low to reasonable, work in a fairly low stress urgent care system, and I make $72/hr and better than average bennies. But I have been a PA for almost 30 years and my resume makes me look wayyyyy better than I am. Sell the sizzle man not the steak. Good luck.

[rev ronin]

Group Health did this, and I suspect Kaiser has continued since acquiring the practice, if they didn't already.

* If a medicare patient had a diagnosis the previous calendar year, you were alerted to each diagnosis, and were expected to address each one--take 'em off if they no longer applied, of course, but realistically, who gets over CKD?  Medicare would pay more for the capitated patient based on the sum total of how sick the patient was, how much they were projected to cost. BUT, each code had to be specifically addressed each year in a face-to-face provider visit to be paid.

* We were also given a list of things to look for.  I remember protein/calorie malnutrition was $7,000 or so more per year, per patient, so if I legitimately suspected a patient had that (e.g., losing weight), I'd order labs to confirm it and code it.  Never got any feedback one way or the other on this, and I wasn't paid on productivity, so there was no personal financial gain--I just wanted to get the maximum legitimate, appropriate payment for the organization based on the actual health of our medicare patients.

[GetMeOuttaThisMess]

On 10/10/2017 at 0:50 PM, sas5814 said:

No that isn't offending but I'd be prepared for them acting like you asked for a private jet. It is all part of the game. I work in Texas where the cost of living is low to reasonable, work in a fairly low stress urgent care system, and I make $72/hr and better than average bennies. But I have been a PA for almost 30 years and my resume makes me look wayyyyy better than I am. Sell the sizzle man not the steak. Good luck.

Note to self:  “Sell the sizzle, not the steak.”  I like that one.