As of July 1, roughly 1,000 physicians at Medical University Hospital in Charleston, S.C., will see their pay based on the number of patients they treat versus the amount of money generated by each department of the academic medical center, according to a Post and Courier report.
The academic medical center employs approximately 1,400 faculty, and the RVU pay cycle will take effect for the clinical side of the house first, according to Heather Woolwine, MUSC spokesperson. She said some departments have already moved to RVUs, and the July change is an effort to standardize the model throughout the enterprise.
The hospital — part of Charleston-based MUSC Health — currently tracks physician RVUs but pays them based on how much revenue their clinical department generates. MUSC President David Cole, MD, says this model can penalize some physicians, such as trauma surgeons, who may be very productive but often treat low-income or uninsured patients. Those high-performing physicians are comparatively underpaid compared to their colleagues who treat large portions of Medicare or privately insured patients, according to Dr. Cole. "It creates a dysfunctional dynamic," he said.
Some physicians work at the 80th percentile of productivity but are paid at the 30th percentile, MUSC College of Medicine Dean Raymond DuBois said told the Post and Courier.
The change has some physicians "livid," in the words of one physician anonymously quoted by the Post and Courier. The physician expressed concern that the medical staff will be forced to treat as many patients as possible and quality will suffer. He or she said the new payment model may also affect physicians' motivation to conduct research, since it puts greater stock on the number of patients seen.
Finally, the physician said supervisors at the hospital have not been able to answer basic questions about the change in recent meetings. Those questions were not specified.
Ms. Woolwine described the payment model as "not exactly trendsetting" and said patient volume "is not the end-all, be-all measure" under the new payment model — it will also account for quality of care and patient outcomes.
"When people see the volume word there — that gets providers nervous," she told Becker's. "That's understandable, but we're certainly looking at a number of factors when determining how to equitably [pay] providers across the board."