Securing Call Coverage: Is employment the answer? 

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When determining the fair market value of on-call compensation rates, the latest Sullivan Cotter survey is the most frequently used resource. At MaxWorth, we don’t believe survey results should be the sole factor in the decision-making process. Surveys are often flawed, and their rates are unsustainable for most organizations, which prohibits broader inclusion in call pay programs. Still, these surveys typically shed light on developing trends in the industry and this year’s update was no exception.


Sullivan Cotter’s 2018 survey revealed that 53% of healthcare organizations struggle to secure physicians to provide call coverage. Many hospitals have tried to fix this problem by employing physicians, which has led to an unprecedented surge in physician employment. Now that more doctors are employed than ever before, why are hospitals still struggling to meet EMTALA requirements?


Independent Physician Concerns


Many facilities struggle to contract with independent groups for on-call coverage where there are service line shortages that will increase physicians’ frequency of taking call. Independent physicians are also reluctant to serve on a call panel where there is a low probability of reimbursement. These issues, which result in petitions for increased payment, contribute to the impulse to employ physicians.


Increased Competition


While employment may seem like a natural solution, it is often financially prohibitive. As competition for physician talent rises, compensation is increasing, and hospitals simply cannot afford to employ all specialties needed on a call panel. Most hospitals are losing money on their employment arrangements as it is. This is especially true for rural facilities. As a result, many facilities now have mixed medical staffs of employed and private practicing physicians.


Mixed Staff Complexities


Mixed medical staffs often become divided around compensation issues like call pay. While call pay is included in employed physicians’ contracts, private practicing physicians are typically paid a per diem. There is often a lack of understanding between these groups concerning how and why each side gets paid, resulting in a perceived lack of fairness and demands for more pay. These demands place administrators, who are already seeking ways to contain costs, in a difficult position.


A Path Forward


It’s becoming clear that employment is at best a part of a larger solution. A holistic approach to compensation is needed that aligns medical staffs around call coverage. MaxWorth’s Call Pay Solution is designed to align the medical staff with a fair, transparent, and inclusive program that also supports the financial sustainability of the hospital.  

Hospitals that have implemented this solution have been able to attract and retain key physicians, allowing them to maintain a strong emergency department and continue to deliver quality care to their communities in today’s challenging environment.



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