The purpose of a co-management relationship is to recognize and appropriately reward participants for developing, managing and improving the quality and efficiency of a particular hospital service line. The arrangement may include one or more physicians, medical groups or faculty practice plans, or a joint-venture entity owned entirely or in part by participating physicians or medical groups.
There are typically two levels of payment under co-management arrangements, explained Mr. Newsad: a base fee, including compensation for service line development, management and oversight, and a bonus fee, paid when predetermined metrics are met. These metrics are determined against the existing performance baseline — “For example, you’ll look at how many surgeries start on time and then you’ll have your baseline and can make a target,” said Mr. Newsad. “Then after the target is achieved, you’ll have a new baseline.” He noted targets can also be maintenance; a surgery group with a near-zero infection rate could receive a bonus fee for keeping that rate.
Under a co-management model, physician compensation is often higher than what it would be under other models. “You’d expect the higher physician pay because the performance metrics mean there’s more of a reward for a higher level of service,” said Mr. Newsad.
The higher compensation comes with more work on the part of the physician partners, in terms of more required documentation and a more active role in the ASC. “There’s no room to be a passive participant in a co-management model,” said Mr. Newsad. “If you’re involved, you’re going to do some work.”
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