Tip of the week: Measure the burden of ED call
September 16, 2010
To establish fair market value for physician ED call services, determine what those services actually are. Use objective data and ask physicians which of their ED services may be weighed. Keep in mind that services include more than procedures performed; they may also include information about the patients. There is no ideal way to measure the burden of call across all involved specialties. However, your report should include the following:
- Number of unassigned patients for each month of the study
- Total number of relative value units (RVU) physicians delivered to unassigned patient cohort
- Number of RVUs each specialty delivered, sorted by physician, within each specialty
- Distribution of diagnosis related groups (DRG) assigned to unassigned patient cohort
- Distribution of ICD-9 codes assigned to unassigned patient cohort
- Overall length of stay for unassigned patient cohort
- Length of stay for the most common DRGs for unassigned patient cohort
- Distribution of payer status related to unassigned patient cohort
- Length of stay related to most common payer classes
- Length of stay by physician within most common DRGs
- Estimated reimbursement per RVU for physician services related to each payer class
- A pro forma reflecting the cost of an ED back up panel-type program to the hospital using various payment rates per RVU to physicians
This week’s tip is from Emergency Department On-Call Strategies, Second Edition, by Jonathan H. Burroughs, MD, MBA, FACPE, CMSL; Martin B. Buser, MPH, FACHE; Roger A. Heroux, MHA, PhD, FACHE; and Richard A. Sheff, MD, CMSL.