2024 Review of Physician and Advanced Practitioner Recruiting Incentives
All of these metrics, with the exception of quality, are volume driven. The more work units (RVUs) physicians generate, the more net reimbursement they collect, the more gross billings they generate, or the more patients they see, the higher their bonus. Today, RVUs are the primary way that employers measure physician volume-based productivity. RVUs were featured in 57% of physician employment contracts offering a salary and production bonus as tracked by the 2024 Review , down from 59% the previous year. Net collections, also a volume-based metric, were featured in 13% of AMN Healthcare’s recruiting engagements this year that offered a production bonus, down from 20% last year. Gross collections, another volume-based metric, were featured in 1% of recruiting engagements that offered a bonus, the same number as last year. The continued widespread use of RVUs (and to a lesser extent net collections and gross billings) illustrates the extent to which physician bonuses remain volume-based. Quality-Based Bonuses Still Not the Standard By contrast, only 26% of contracts tracked in the 2024 Review that featured a production bonus included one or more quality-based metrics, such as patient satisfaction scores, readmission rates or others, up marginally from 25% last year but down from 31% the year before that. Major initiatives have been made in recent years by both payors and healthcare organizations to steer physician payments toward quality metrics and away from volume-based formulas. The goal of finding the right compensation formula – one that rewards physicians for quality but also ensures they stay productive – has been elusive. Volume-based production-based formulas are relatively straight forward and remain common in physician contracts, while the Review indicates that the use of quality-based formulas is not generally advancing. In instances where the production bonus includes quality metrics, the 2024 Review indicates that, on average, 10% of the physician’s total compensation will be determined by quality, down from 14% last year and down from 11% the year prior to that. The 2024 Review therefore suggests that the impact of quality metrics on total physician compensation is likely to be less than the impact of volume-based metrics.
Signing Bonuses and CME Signing bonuses were offered in 51% of the recruiting assignments AMN Healthcare conducted in the 2024 Review period, down from 63% the previous year. Signing bonuses are a common recruiting incentive used by hospitals and medical groups and provide an additional impetus for candidates who may be considering multiple opportunities, offering an immediate, tangible reward that can separate one opportunity from another similar opportunity. The decline is the number of search engagements offering signing bonus may be due to the relatively high number of search engagements AMN Healthcare conducted for academic centers, urgent care clinics and other venues that often do not offer signing bonuses. Signing bonuses offered to physicians tracked in the 2024 Review averaged $31,473, down from $37,472 last year. Signing bonuses offered to NPs and PAs as tracked in the 2024 Review averaged $11,758, up from $8,355 last year.
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