The enduring rise of call pay doesn't have to be a liability
When MaxWorth first created the Call Pay Solution, on-call compensation was one of the most contentious topics in healthcare. At a time when more and more physicians were demanding to be paid for call, most administrators were reluctant to establish a call pay program, and many were adamantly against it. Administrators understood that it would be difficult to stop paying for call once they started and that call-pay rates would continue to rise as paying for call became more common.
Meanwhile, ED physicians were being asked to do more for less. Declining reimbursements, increased volume, increased liability, and increased regulations all exasperated the issue and added to physicians’ frustrations.
Commonplace, but still contentious
Since the early days of call pay, it has become common practice to pay many specialties for taking unassigned call. However, even though call pay is common now, it’s still a source of contention at many organizations. Today, our conversations with clients are about how much, not if, a specialty is getting paid. Underlying feelings of distrust and a perceived lack of fairness and transparency are still at the center of the conflict.
Many hospitals have alleviated agitation around call pay with a variety of solutions and arrangements that are proving to be financially unsustainable. The cost of call pay (in whatever form it takes) is threatening the long-term viability of some hospitals, especially smaller, rural facilities. Rural hospitals are closing at alarming rates, and according to the Center for Healthcare Quality and Payment Reform, most spending at rural hospitals is aimed at delivering emergency services.
Why is the cost of call pay on the rise?
Many factors play into the rise of the cost of call pay, and they can vary depending on which solution is being examined. But there are two contributing factors that have impacted nearly everyone in healthcare: the increased demand for care and the physician shortage.
Demand for care
According to AMN Healthcare, demand for care, “remains high and will continue to grow,” due to America’s aging population.
Demand for care is also impacted by the fact that Amerians, particularly the uninsured, rely heavily on the ED as opposed to other resources like primary care providers. A 2017 study conducted by the University of Maryland School of Medicine found that when Americans need health care, they turn to the emergency room half the time.
Given the nature of its root causes, the increased demand for care isn’t likely to subside anytime soon, and this is made more concerning by the fact that the physician shortage is expected to increase. The latest data published by the AAMC projects that the primary care provider shortage will fall between 21,400 and 55,200 by the year 2033.
How MaxWorth can help
The top contributing factors to the rising cost of call pay are expected to persist for the foreseeable future, which means we can expect the cost to continue to rise. The good news is, our Call Pay Solution can help hospitals continue to pay for call without sacrificing their financial viability.
Our process for determining call-pay rates is physician-driven. We bring medical staffs together to create a fairness standard that's applied to all call-pay rates. From the outset, this approach diverges from the divisive nature of single-specialty negotiations.
The program also offers physicians a meaningful benefit they can’t typically obtain on their own. Being able to offer this benefit creates market distinction for the hospital, aiding them in physician recruitment and retention.
The Call Pay Solution also provides hospitals with a way to recover a portion of their call-pay expense, which helps to ensure both the long-term sustainability of the program and the long-term viability of the organization itself.
The Call Pay Solution may be a right fit for hospitals working with independent providers and paying a per-diem for call availability and for hospitals that are paying employed physicians for all or a portion of their call availability outside of their base contract. It can be incorporated into a broader strategy in order to allow hospitals to meet the needs of their emergency department in a more sustainable way.
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