Everybody's Negotiating; You Should, Too!
Also: More is better; preserving the workforce; scope of practice; updated pay reports; and prioritizing providers
Top of the week
Negotiating over money. We do it all the time in our society. We negotiate prices for buying & selling homes, and vehicles. The universal tug-o-war in these transactions is that the seller of goods & services always wants to deliver product while collecting the highest price. The buyer wants to pay the least amount of money yet get the most product. EM contract management groups (CMGs) engage in the same tussle when trying to negotiate the best reimbursement from insurance payers.
This useful article advises CMGs how to best negotiate with insurance payers in order to maximize reimbursement. There’s no question that in recent years there has been significant disagreement between CMGs and insurance payers over reimbursement rates. This disagreement led to out of network billing, and eventually the No Surprises Act. So, let’s say that a CMG succeeds in negotiating favorable reimbursement rates. How does that money get distributed to provider pay?
Now the tug-o-war negotiations is between the CMG employer and the EM provider. There will always be disagreement between employers and providers over pay. Employers want to control (limit) pay and providers want the most money they can get. There must be a middle ground.
Though this article advises CMGs how to approach negotiations with payers for top reimbursement, there are some applicable points that providers can use when negotiating for their own pay. Note that negotiating provider pay is not restricted to applying for a vacant position. Providers can talk to their employers at any time to negotiate an increase in pay.
When it comes to negotiating pay, a resounding theme in this article is transparency of data. Providers should routinely have access to specific data. Of course, the data should include patients per hour, and RVUs per hour. Providers should not only see their own data, but also all providers’ data for comparison's sake. It is also valuable to highlight how much high acuity an EM NP/PA is billing; this includes critical care billing. This may show how much a CMG depends on specific EM NPs/PAs to augment the physician staff managing high acuity patients when an additional physician shift cannot be added. If a department staffs a low acuity shift, EM NPs/PAs should market how quickly they are clearing ESI 4/5’s from the waiting room. This is a metric that hospital CEOs like.
Gone should be the era of EM NPs & PAs being viewed simply as “just employees.” EM NPs & PAs have generated great revenue for their CMGs. They create profit margins that finance attractive physician pay. During shifts, EM NPs & PAs help clear the runway for physicians to maximize focus on the sickest patients in the ED. All this makes EM NPs & PAs a critical necessity for CMGs to successfully staff and manage EDs. As such, now is the time for EM NPs & PAs to be consistently compensated commensurate with the revenue they generate, and the wealth they are building for others. Develop the argument for higher pay. Frame your position and defend it. Use data to justify your argument. Get paid what you are worth.
Emergency Medicine
The unification of providers
This interesting article examines obstacles to unifying EPs. Among the different members of this group, he pays special attention to EPs that are neither promoters nor detractors of EP constituency groups: EPs on the margins. The author talks about maximizing the diversity that exists in the EP ranks. EM NPs & PAs can benefit from the same approach. I do believe EM is a team sport. However, it is no secret that there is considerable discussion about limiting EM NP/PA scope in the ED, and even limiting EM NP/PA presence in the department. EM NPs & PAs would benefit from consolidating the power of their numbers to promote their value, protect their current standing in the department, and ensure future growth opportunities in the market.
House of Medicine
Workforce shortages
Sometimes it’s hard to see the value of things from far away. However, when you’re looking for solutions to problems in your own backyard, new perspectives may emerge. State lawmakers are seeing benefit in letting PAs do more.
Quiet quitting
Employee burnout has been well documented. Retaining employees has been an increasing challenge. When employees leave jobs, there is a direct response by employers: fill the vacancy. However, what happens when the employee doesn’t leave the job?
Everybody hurts sometimes
Medical providers have dedicated their careers to taking care of others; but who’s taking care of the providers? This is a concerning article of a physician who turned to his employer for help.
New York scope of practice
Scope of practice has been in the news quite a bit this year. This article discusses a robust campaign that defeated PA efforts to expand scope of practice in New York state.
Hospitals, Health Systems, and More
Where does your pay rank?
NPs are leading growth in healthcare jobs in America. Checkout the updated pay information for the 8 fastest-growing healthcare jobs.
Closing the distance between providers and patients
UC Davis Health has identified NPs & PAs as a valuable resource that increases patient access to quality care. Addressing provider shortages will require out-of-the-box thinking. This out-of-the-clinic solution will become more popular.
The cost of care
State lawmakers take the initiative on addressing massive patient medical debt. The actions are varied, but all are directed toward protecting patients, or at least mitigating the negative effects of healthcare care debt. Historically, patients have been at a disadvantage when it comes to full transparency and clarity of health care pricing and charges. However, federal lawmakers are taking their own steps to examine large corporate mergers and the impact that consolidation has on competitive healthcare pricing.
The Good Stuff
Somebody is listening
Skilled healthcare talent is a scarce resource that is expensive to replace. It is amazing how frequent highly skilled talent is mismanaged. It seems, however, that UNC has developed a model that other organizations can follow.
When NPs, PAs, and physicians unite
Providing healthcare is a team sport. All face very similar employment challenges. Here’s a good example of joining forces to improve working conditions.
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