Creighton Medical Associates (CMA) is the integrated practice for Creighton University Medical School’s faculty members. The group consists of approximately 225 physicians with nearly 30 different specialties.
Creighton Medical Associates and the Creighton School of Medicine determined that restructuring the physician compensation plan was needed to better account for and reward its clinical and teaching missions by its physician faculty. It desired to establish a strategic compensation philosophy that recognizes and rewards the teaching effort and is deemed fair by the physician faculty to reward clinical effort based on a wRVU methodology. In addition, emphasis was needed to reward EMR adoption toward quality improvement and meeting federal meaningful use criteria.
Wipfli’s first step was to create a better context in which to launch the compensation redesign effort. This was done through constructing benchmark comparisons of physicians’ productivity and compensation to national academic medical center data as well as interviewing key stakeholders. The findings indicated that although the physicians were generally more productive than and being paid above the industry median, there was little clarity about how the faculty was and should be dividing its efforts between clinical work, teaching and research. As a result we worked with the ad hoc compensation committee to develop key guiding principles for the new plan:
- Encourage clinical productivity and reduce the variation
- Require that the new plan is self-funded (“No margin, no mission”), including capital requirements
- Encourage teaching excellence and efficiency
We then worked with the client to develop accurate baseline data that segregated each physician’s FTE level by clinical, teaching, and research activities. As a result, clearer expectations and goals were established for each activity, and the financial impact of greater clinical productivity was measured.
Clinical productivity has increased within the group, and clinical variation has also been reduced. Incentives are now being considered both for various quality metrics (e.g., PQRI and clinical productivity rewards) and for development of a greater sense of “group” and divisional unity within CMA. Equally importantly, each physician now has greater clarity about how to allot and measure their time to ensure accountability is increasingly embraced throughout CMA.