A variety of factors can complicate hospice physician compensation. The top three questions we help hospice providers answer are discussed in this article. When a hospice client asks these questions, there are a few different options that we ask them to consider. If you have these or other hospice physician compensation questions, contact us.
Hospices face one of these complicating factors because they commonly contract with multiple physicians for services. While each hospice typically designates a single physician to be the medical director, it is often necessary to have additional physicians who provide backup to the medical director, participate in interdisciplinary team meetings, and conduct face-to-face patient encounters, etc. These additional physicians may only provide a few hours of service each week or month to the hospice and usually have private practices and responsibilities outside of the hospice. Standard best practice to avoid inappropriate referral relationships is for hospices to pay physicians for services rendered on an hourly basis, instead of a monthly stipend. However, it can be difficult to get busy physicians to keep documentation of their services and submit time records. Question #1: How do we pay physicians an hourly rate if they don't document their time?
Secondly, hospices are required to make physician services routinely available to patients on a 24/7 basis. Hospice nurses are often on-call to deal with after-hour patient needs. However, an on-call physician will also take phone calls and be available for situations that require a physician. Therefore, hospices ask about the value of on-call time and how to compensate physicians for this burden. Question #2: What do we pay our medical director for being on-call 24/7?
Finally, another frequent question relates to physician travel time. Hospices often contract with physicians to travel to patients' homes and conduct the face-to-face encounters that are required by Medicare. These home visits may require a significant amount of physician travel time. Consequently, hospices frequently ask Question #3: How do we compensate physicians for all the drive time?
BFMV has provided help with these and other hospice physician compensation questions for hospice providers nationwide. For additional information pertaining to hospice medical director compensation, check out our free ebook on compensation philosophies for home health and hospice medical directors.
This article has been updated from a previous version published in 2016.