Society For Academic Emergency Medicine
Emergency Medicine at a Glance Pay range (MGMA 25th and 75th percentiles, 2000): $170,000 to $224,000.
Pay direction: Moderately upward. Recruiters, practice managers and MGMA all report increases in 2%-6% range in past year. But increases could slow down or stall in face of general revenue-cost squeeze affecting most specialties. Continued demand for physicians buoyed by rise in procedures in 75% of ERs around the country; about 75% of those report volume increases of 11% or more in last 12 to 18 months.
Number (nationwide): 32,000 (1998 estimate by American College of Emergency Physicians).
Entries to and exits from field per year: 500 new board-certified ER physicians per year. About 40% of ER physicians now certified, still a shortage situation but much less dramatic than 10 years ago. Other physicians enter ER practice through variety of paths.
What emergency physicians do/subspecialties: Primarily staff ERs in roughly 5,000 U.S. hospitals that have them. In 1988-98, 1,128 emergency departments closed, nearly 500 of them because their hospitals closed, but closings have slowed in last 2-3 years.
Common reimbursement methods: Discounted fee-for-service. High percentage of unpaid work. Reimbursement prices have been stagnant overall for years. Commercial payers are best despite many refusals to pay and some recent price cuts; next is Medicare, followed by Medicaid (paying as little as 15%-20% of gross charges), and individual payers (who as a group end up paying about 10%). Medicare RVU procedure values fell about 3% this year, exacerbating effect of 5.4% RVU dollar value cut. CMS also is considering documentation changes that could force lower-dollar coding for many services. Cost squeeze is pushing some hospitals to implement production pay plans for ER physicians, who generally are paid for time (hourly or daily).
Common group structures: Nearly half of emergency physicians are employees of the hospitals in which they work. Many others work for medical groups with contracts to supply ER services to one or more hospitals. Still others work for practice management companies serving many hospitals. And others work for academic, health system or physician-owned multispecialty practices.
Main professional society: American College of Emergency Physicians, Irving, Texas, (800) 798-1822, and Washington, D.C., (800) 320-0610, www.acep.org. Other PCR items on emergency medicine: (1) revenues stop rising in field, 2/02, p. 3; (2) compensation trends in 2000, 1/31/01, p. 4.
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