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Home / News & IndustryManaged Care Insight and Analysis
Updated: Nov. 4, 2008
Hospital Expenditures For Physician On-Call Pay Rates Increase
2.7 Million

Physician on-call pay expenditures have increased over the past year, according to a survey released by Sullivan, Cotter and Associates Inc.

The 2008 Physician On-Call Pay Survey Report has data from 132 healthcare organizations nationwide and outlines physician on-call pay practices and rates paid for 33 physician specialty areas along with data reported for trauma centers and non-trauma centers.

Nearly two-thirds of the survey participants report that their physician on-call pay expenditures have increased within the past 12 months.

From 2006 to 2008, the median expenditures reported by trauma centers for physician on-call pay have increased by 88 percent; the median expenditures in non-trauma centers increased by 91 percent.

The practices vary in terms of how a physician is compensated when called in to provide services. "To secure the required call coverage, organizations may have to supplement traditional professional fees with subsidies for unassigned/under insured patients, fee-for-service payments, flat hourly rates and malpractice subsidies," according to Kim Mobley, the survey director and principal of SullivanCotter.

These subsidies may also apply to the follow-up care to an unassigned patient.

The majority of the survey participants (86 percent) report providing on-call pay to non-employed physicians with admitting privileges; about one-half (54 percent) report providing on-call pay to their employed physicians.

The majority of the survey participants (91 percent) report that the physician on-call pay is funded solely by the hospital; however, 8 percent report that the medical group is also providing some of the funding.

Not all physicians receive on-call pay. According to Mobley, another emerging trend is pay for "excess call only;" provided only after a specified number of shifts or hours.

According to the survey, 21 percent of the organizations have adopted the policy.

Mobley believes the percent of organizations adopting this approach to physician on-call pay will likely increase in light of the ever increasing on-call pay expenditures. Coupled with the number of specialties requiring on-call pay and the Office of Inspector General’s September 2007 Advisory Opinion, which suggested that physician on-call pay should be related to the amount of call provided and the likelihood of being called in, the trend could continue.

The key variables impacting physician on-call pay rates, according to the survey, are the rates of local and national markets, frequency of the call coverage provided and the likelihood of being called in for service.

The survey identified a significant variance in the on-call rates paid by specialty; some specialties are far more likely to receive on-call pay than are others. "This data represents national market norms. Local market rates paid to physicians providing call coverage can vary," said Mobley, who notes that on-call pay is still an emerging trend.

"Some highly compensated specialties receive relatively low on-call rates of pay. These samespecialties are often the ones that are not as likely to receive on-call pay. While physician on-call pay is still an evolving market trend, it appears that there is some relationship between the likelihood of being called in to work and the on-call rate paid," she added.

Address: Sullivan Cotter and Associates, 3011 West Grand Blvd., Suite 2800, Detroit, MI 48202; (313) 872-1760,

  This article was taken from:
The Executive Report on Physician Organizations

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