Physician Assistant

[PAinIL]

I am a PA with 25 years of experience and currently my medical group is switching our compensation to an RVU based system. Can anyone in outpatient primary care share with me their dollar amount per RVU so I can negotiate properly? I’ve been reading about the tiered RVU system and I like the numbers but need to know where to start the conversation. Thanks for your help!

[mgriffiths]

I don't work primary care anymore, but when I did my various jobs were as follows:

• $10 per RVU over 333 RVUs produced in a single month
• The above changed to be (if I recall correctly, but it would be close) $15/RVU over 300 and then $18/RVU over 350 in a single month.  So, if I produced 400 RVUs, I would earn (50 x $15) + (50 x $18) for a total bonus of $1,650.
• Different employer than the two processes listed above, bonus was based on annual RVU production, not monthly.  I don't remember the threshold, but it was the MGMA median RVU production (maybe 3400 RVUs/year...but don't quote me) and anything above was paid at ~$15/RVU.  Then, if you produced above the MGMA 75th percentile (I'm not even going to give a guess, I don't remember that number) then ALL of your RVUs (50th percentile and above) were paid at ~$18.75/RVU.  I do know that since I have transitioned away from FM to ortho the RVU thresholds and money paid per bonus RVU has changed.

[PAinIL]

Thank you for your insight! I’ll check the current MGMA stats. 

[sas5814]

I have worked on productivity but not specifically on RVUs so I don't have much to contribute in that regard. The only thing I'd share is who controls your schedule is really important. If you don't have some control you may find yourself buried in patients who don't contribute much to RVUs or, worse, a shrinking schedule that doesn't keep you busy enough.

My clinic was a RHC where, for the most part, reimbursement per patient was pretty fixed. I found people avoiding t consuming visits such as procedures because we got paid the same per visit across the board. Why do a minor surgery when you could see 3 colds in that same period of time? I know its different with RVUs but I have always been mindful of who controls the schedule.

[mgriffiths]

35 minutes ago, sas5814 said:

I have worked on productivity but not specifically on RVUs so I don't have much to contribute in that regard. The only thing I'd share is who controls your schedule is really important. If you don't have some control you may find yourself buried in patients who don't contribute much to RVUs or, worse, a shrinking schedule that doesn't keep you busy enough.

My clinic was a RHC where, for the most part, reimbursement per patient was pretty fixed. I found people avoiding t consuming visits such as procedures because we got paid the same per visit across the board. Why do a minor surgery when you could see 3 colds in that same period of time? I know its different with RVUs but I have always been mindful of who controls the schedule.

Absolutely 100% true, but PAinIL I would also highly recommend not getting too caught up in productivity.  It has the ability to consume you and worse can lead to worse patient care because something that could be handled by a PCP gets referred out because it's not a "productively efficient" visit/procedure.  I say this from experience in regards to consuming me.  Doesn't mean ignore it altogether...there has to be a balance.