Optimizing Physician Compensation: Streamlining wRVU Models for OB/GYN Department Growth

Improved wRVU accuracy and standardized compensation to boost trust, engagement, and growth for a multi-hospital OB/GYN department.

Challenge

The OB/GYN department at a Southeast healthcare system faced challenges with inconsistent physician compensation across its hospitals. Two distinct compensation models yielded varying results due to factors like differing practice patterns and call coverage. Additionally, the manual calculation process for work RVUs (wRVUs) led to inaccuracies, eroding physicians' trust and fueling interest in moving away from the wRVU-based model, despite high productivity levels.

Solution

To resolve the wRVU calculation issues, we introduced workflow changes to capture antepartum wRVUs at the time of service and adjust the global wRVU at delivery, eliminating the risk of double crediting. This adjustment restored physicians' confidence in the accuracy of the data, ensuring they received real-time credit for the care they provided. With reliable wRVU data available, we implemented a tiered compensation model to support the department’s expansion across additional coverage areas. All changes were thoroughly tested for fair market value compliance, ensuring adherence to industry standards.

Approach

Step 1Data Analysis for Informed Recommendations
We conducted thorough quantitative and qualitative analyses to guide our recommendations for a revised compensation model.
Step 2Industry Best Practices on wRVU Measurement
We shared OB/GYN industry best practices and proposed a strategy to continue measuring wRVUs effectively.
Step 3Collaborative Development with Key Stakeholders
We worked closely with physician and administrative leaders to gather physician input, encourage engagement, and ensure that incentives aligned with organizational goals.
Step 4Transparent Communication of the New Model
We presented the new compensation model in group meetings and provided each physician with personalized schedules comparing the new model to their historical compensation.

Conclusion

Coker successfully guided the OB/GYN department in resolving its compensation challenges by enhancing wRVU calculation processes, rebuilding trust in the data, and implementing a tiered compensation model. Collaborating with physician and administrative leaders, we ensured the new model aligned with industry best practices, organizational goals, and fair market value standards, enabling consistent compensation and supporting the department’s growth across multiple hospitals.

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Real-Time Credit of Antepartum Care

Results At a Glance

-9Eliminated the 9-month waiting period for physicians providing antepartum care for global deliveries.
100%Assigned credit to each physician for all care provided, rather than limiting credit to the majority share.
$890KEnhanced wRVU reporting accuracy by removing back-end manual calculations. The previous process over-credited wRVUs, leading to approximately $890K in excess compensation for 13 physicians in one calendar year. The new automated process has corrected this discrepancy.

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