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MGMA 2009 Physician Compensation Survey
Cautions Users on Productivity-based Compensation

In its 2009 Physician Compensation and Production Survey, the Medical Group Management Association ("MGMA") has cautioned users about the possibility of misunderstanding a commonly utilized productivity metric reported by the survey.

 
Physician compensation plans based on a value per work relative value unit ("wRVU") are increasingly popular in today's healthcare marketplace. Several physician compensation surveys, including the MGMA, the American Medical Group Association, and Sullivan Cotter, report wRVUs by major percentile (i.e., 25th, median, 75th and 90th). In designing productivity-based compensation plans, there is often a tendency to select a compensation per wRVU rate that is above the median (following the logic that, by definition, 50% of physicians are compensated above the median). In addition, many employers may conclude that compensation should match productivity, and thus, a physician whose wRVUs benchmark at the 75th percentile should be paid the 75th percentile compensation per wRVU rate. Other employers may seek to create incentive plans with increasing compensation per wRVU rates for higher levels of productivity.
 
However, such thinking about the relationship of productivity to the compensation per wRVU rate is based on a misunderstanding of the survey data. In its 2009 survey, MGMA warns users that the most highly compensated physicians generally realize the lowest compensation per wRVU. Accordingly, well-intentioned employment arrangements can result in overcompensation to physicians
 

For example, if a general surgeon is compensated for 90th percentile productivity at the 90th percentile compensation per wRVU, the resulting total cash compensation would be ~$828,000 (i.e., 10,681 wRVUs times $77.51 per wRVU). However, the 90th percentile cash compensation reported by MGMA is only $545,000, resulting in possible overcompensation of $283,000.

 

FMV Pitfall

In setting rates under compensation per wRVU employment arrangements, employers must consider the inverse relationship between total cash compensation and compensation per wRVU. To ensure that a wRVU-based compensation arrangement is consistent with fair market value, the physician's resulting compensation at various wRVU productivity levels should be compared to the benchmark cash compensation at similar percentile thresholds.

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