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RVU structure compensation


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RVU compensation is quite common as a bonus system beyond a base salary.  I am aware of some that are paid strictly on RVUs, but I don't believe that is quite as common.

 

Pros: you are getting paid to work above and beyond.  You get a cut when your schedule gets overloaded.

Cons: often your base salary is lowered because you will "make it up" in the bonus if you work hard...counter productive in my opinion, you lose RVUs when you go on vacation, have meetings, CME time, etc. - basically if you're not producing RVUs you are hurting your income, can increase over billing, wastes time when you chart more than you need to to "justify" the overcoding, burnout from pushing to make a larger bonus

 

Mayo clinic from my understanding has done away with productivity bonuses, or is in the process due to mainly concerns for burnout.  They found that productivity and reimbursements actually went up as providers didn't overcode and waste time charting to justify so were more efficient and providers who undercoded tended to code more appropriately (i.e. higher) when the RVU bonus was removed.  So, using that example the RVU bonus works backwards from an employer and employee point of view.

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  • 2 weeks later...

Interviewed with a place that does strictly RVUs, no base salary. You don't get paid for your no-show patients, cancellations, or gaps in the schedule.

This position was in psychiatry, no less. Needless to say, I turned away running.

 

One of those places that likes to throw out the word "lucrative" as a way to sell you the idea that you earn based on how hard you work. 

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18 hours ago, pa-wannabe said:

One of those places that likes to throw out the word "lucrative" as a way to sell you the idea that you earn based on how hard you work. 

I would not be against RVU only income, but it would have to make sense.  I would require a base salary for 1-2 years as patient base is established, but also would need control over how to run my practice...no show fees, discharge patients, etc.

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This is the second time typing this since I didn't know you needed to be a member to post so my initial entry was tossed. They might let you know that before you waste your time. I am going to be new to the RVU situation. I am presently in a 2 provider family practice. See 21-23 patients a day, use to see more before the EMR, up to 30 a day. I usually bill 99214 my monthly RVU's are average 415 the physician averages 435. I am paid $120,000, (which is the max salary for the institution) 200 hours vacation, 5 days cme, $2,500 cme fund, licensing fees, dea fee, nccpa fees and no penalty for sick days, a 403b with 3% match. I think that covers it. We have been acquired by a for profit corporation. They reimburse by RVU but there is a base salary but I have no idea what it is. There are no benefits, except licensing and malpractice. You are responsible for your own CME and there are no paid vacations. I have no idea what RVU's they are expecting but I would think about 5,000. I have no idea when the bonus kicks in (after 5000 RVU's or the amount.). I am going to ask for a base salary of $135,000 to make up for the loss of the benefits How much is appropriate for the RVU bonus in cash per RVU and at what level (after 4,000). Any information would be helpful. Not that it matters but my days are typically 12 hours, the EMR requires work at home and I need to be on the computers at 5:30 in the morning to get things done before the office which include preparing transition of care visits in advance because there is no time during the day. I even need to take my computer on vacation because there is just more work that can be handled. Of course, none of this "reimbursed" it's just required so the machine functions. Since this is not billable there is no RVU assigned. I've been in practice for 44 years. Any input would be appreciated.

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To have an RVU threshold of 5,000/year is asinine.  Average RVUs produced by PAs is 3300 per year in family practice.  Therefore, if the salary is average then the threshold should be around the average.  If the threshold is going to be above the listed 99th percentile (around 4500/year), then the salary should be 99th percentile.

 

raymondpatrick - your initial gig looked great!  The new is ridiculous.  Requiring you to prep charts at home and do work on vacation is ludicrous.  That is just wrong.  A $135k salary sounds great...but I would greatly prefer my $110k salary with a bonus potential after 3300 RVUs with the potential to pick up extra UC shifts paid hourly where I walk in to work at 7:30 and out the door at 5:15 with 100% of my work DONE (note that timeline includes a 30 minute lunch).

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Thanks for your response, what do you think the dollar amount should be after 3,300 RVU's? (an anticipated 1,680 RVU's bonus?) The extra after hours computer work is just part of the beast as it eats and breaths today. I think I need to figure something into the salary, bonus RUV's etc. to account for this because it can't be altered and may well get worse as we transition to our third EMR in a year and a completely new practice location. There is literally rarely a day in the week that doesn't require some computer attention. Did you mean your stated 110K salary to actually be my present 120K, I couldn't tell because you said "but I would prefer by $110K salary"? Thanks again.

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I am currently paid $19.33 per RVU, but if I reach the 75th percentile (somewhere around 4300 RVUs) then the bonus (for ALL bonus RVUs) jumps to ~$22.

 

My salary is currently $110k and seems equivalent to your current $120k, except mine includes health insurance and you didn't mention that specifically.  Also, while I get $2500 CME, all licensing and so forth would come from that as well.  I plan to negotiate that a bit when the time comes.

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My PTO (one "bucket") accumulates with each paycheck - except CME which is separate at 40 hours or 1 week.  PTO is 9.86 hours per paycheck = 256.36 hours/year = about 6.4 weeks/year.  There are some other PTO things available for very specific situations like bereavement PTO which is 3 days I believe, but they don't count or accumulate or anything...it's just there if you unfortunately need it.

 

We also can carry over PTO from year to year, and my understanding there is no maximum (but this is likely going to change soon)...and I can also "buy down" my PTO at my hourly rate (they reverse engineer from my base salary somehow...I assume $110k/2000hrs or $55/hr).

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