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Payment for on-call coverage becoming more common
■ Rates must be fair market value to avoid violating rules on doctor-hospital alliances.
By Victoria Stagg Elliott — Posted May 9, 2011
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A growing percentage of physicians get some form of payment for providing on-call coverage, according to a report issued April 20 by the Medical Group Management Assn.
Hospitals have had a harder time securing on-call coverage during the past few years, and the number of physicians receiving compensation for the service grew from 59% in 2009 to 65% in 2010.
"Physicians want to be compensated for call, and your younger, newer physicians are much more tuned into that than older physicians," said Jeffrey B. Milburn, an independent consultant with MGMA Health Care Consulting Group in Englewood, Colo. "Physicians realize the value of their time and services and are negotiating compensation for on-call coverage."
How physicians are compensated for on-call coverage shifted slightly. A daily stipend was the most common form of payment, with 35% of physicians providing call coverage paid this way in 2010 compared with 33% in 2009. But more are being paid annually. An additional 21% received annual pay in 2010, an increase from 14% in 2009. About 6% were paid by the hour in 2010, down from 8% in 2009.
But experts said physicians seeking payment for on-call coverage need to balance several concerns. Any money paid must be fair market value to avoid running afoul of regulations governing hospital-physician relationships. Nonprofit hospitals need to be aware of Internal Revenue Service regulations to maintain that status.
Experts said that although payment for call coverage is becoming more common nationally, there are wide variations by region, group size and medical specialty.
"Payment for call is a trend, but it depends on your market," Milburn said. "In some areas, paying for call coverage is solidifying. In other areas, it hasn't even started."