compensation to the productivity (as measured by work RVU). This is completed with the use of independent compensation surveys and analyzing expected productivity. The most commonly used “government endorsed” surveys to accomplish this task are: • American Medical Group Association (AMGA) Medical Group Compensation and Financial Survey • Medical Group Management Association (MGMA) Physician Compensation and Production Survey • SullivanCotter and Associates, Inc. (SullivanCotter) Physician Compensation and Productivity Survey The most common methods of clinical compensation arrangements utilizing work RVU are: 1. Compensation per work RVU: Also known as an “eat what you kill” model. Providers are paid a set dollar conversion rate for each work RVU generated. Work RVU
$/Work RVU
8,000
$50
Compensation $400,000
2. Graduated scale: Under this model, providers are paid dollar conversion rates per work RVU based on a graduated scale. Work RVU Scale
Work RVU
$/Work RVU
Compensation
Affordable Care Act to test innovative payment and service delivery models that have the potential to reduce Medicare, Medicaid or Children’s Health Insurance Program (CHIP) expenditures while preserving or enhancing the quality of care for beneficiaries. Provider and hospital expenses are linked to make a single payment for an episode of care with bundled payment models. There are several bundled payment models, including the Oncology Care Model. In this model, oncology practices receive monthly care management fees and are eligible for bonus payments if they lower overall Medicare spending and meet quality goals for episodes of chemotherapy and related care.
4.4 Average Salary According to the annual compensation report conducted by Medscape, urologists earn $417,000 per year on average, up from $408,000 as reported in 2019. Average incentive bonuses were $64,000, with 46% of respondents achieving that bonus. The most recent data available is for 2020.
4.5 Resources • A merican Medical Group Association https://www.amga.org • S ullivanCotter https://www.sullivancotter.com • C MS Innovation Center https://innovation.cms.gov
0 - 2,666
2,666
$45.00
$119,970
2,667 5,333
2,666
$50.00
$133,300
• C MS Quality Payment Program https://qpp.cms.gov
5,334+
2,666
$55.00
$146,630
5. FINANCIAL MANAGEMENT
APPROXIMATE TOTAL: $400,000
3. Base guarantee plus productivity bonus: Under this model, providers are paid a base guarantee and receive incentive/productivity compensation for every work RVU generated above a predetermined threshold. Base Salary
Threshold
$266,650
$/Work RVU $50.00
5,333
Bonus $133,350
Work RVU 8,000
Compensation $400,000
4.3 Bundled Payments The Bundled Payments for Care Improvement (BPCI) initiative was developed by the Center for Medicare and Medicaid Innovation (Innovation Center). The Innovation Center was created by the AUAnet.org
This section was authored by Dima Raskolnikov, MD, Jonathan Wingate, MD and Mathew Sorensen, MD. Note from the authors: this text does not constitute professional financial, accounting, legal or any other advice; we recommend consulting a professional if such services are desired. The products referenced below are meant as examples and are not specifically endorsed by the authors or the AUA. The purpose of this section is to provide a framework for you to consider critical aspects of financial management during an important time in your career. It is not meant to be exhaustive. Just as it wouldn’t be possible for you to decide whether academic medicine or private practice is a better fit solely by reading this manual, so too with decisions related to personal finance. Instead, this section is meant to serve as a guide for further reading and discussion. We hope that you find it helpful.
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