Health provider pay package set for Oct. 1
Health Services Executive Director Connie Davis addresses the Tribal Council on Sept. 11 at the W.W. Keeler Tribal Complex in Tahlequah, Okla. Davis said that Health Services would implement a new provider compensation package on Oct. 1. COURTESY
TAHLEQUAH, Okla. – Health Services officials were expected to implement a new provider compensation package on Oct. 1 after soliciting feedback from Tribal Councilors and the Health System Provider Compensation Committee.
“That’s what were pushing for,” Health Services Executive Director Connie Davis said of the projected implementation date. Oct. 1 marks the beginning of fiscal year 2018. “We’re prepping the contracts right now anticipating everything going through.”
Davis declined to share details of the new compensation package, but said the plan was supposed to have been finalized in a Sept. 13 meeting with Principal Chief Bill John Baker, Treasurer Lacey Horn and Secretary of State Chuck Hoskin Jr.
Compensation Committee member Dr. Johnson Gourd, a physician at Three Rivers Health Center in Muskogee, said as of Sept. 19 providers had not received an official document with the changes.
“We have not got official word on that,” he said. “I don’t know what the package entails or what the final numbers are. I don’t know even what to expect. Everything is just hearsay at this point.”
In an April 21 letter, the Compensation Committee asked Health Services officials to increase base salaries and incentives for providers to “recruit and retain top quality (health care) providers” to care for patients.
The letter states CN providers are paid $48,000 less annually than the $218,000 base salary outlined in a 2016 physician compensation report and that an increase in base pay at CN has happened once in eight years.
Compensation Committee members said this has led to recruitment difficulties, a loss in providers and increased wait times for patients as remaining providers “experience the undue burden of taking on the additional workload for those many empty positions.”
“You almost feel guilty to be sitting there arguing for more pay, but we want to demonstrate that this is not a money grab by the providers,” Gourd said. “This is simply what the market standards are currently. We’re not saying that the CN is bad. We love it. That’s why we stay. It’s just this is what we are seeing. It’s not a blame game, but trying to keep your head above water as the market changes around you.”
In response to the letter, the Tribal Council held a May 15 meeting in which Davis and Executive Medical Director James Stallcup proposed annual bonuses based on relative value units or RVUs.
According to a physician search and consulting firm, RVUs calculate work volume done by a physician when treating patients. The more complex the visit, the more RVUs a physician earns.
When translating RVUs to revenue, Stallcup said the hospital collects $120 from third-party billing for every RVU delivered. Once the provider is paid a share of roughly $65, the facility is left with approximately $55.
Stallcup said the RVU proposal could increase positive revenue per RVU by 12.5 percent while keeping the base salary increase possibility, which could happen in the first quarter after the RVU system was operational.
However, Gourd and other Compensation Committee members voiced concerns about moving to RVU-based compensation before raising base pay because of “inefficiencies” in the electronic health records system.
Gourd said the EHR system has decreased the amount of patients he sees and does not allow him “control of all variables” to complete his job efficiently. He also raised concerns about new providers entering under RVU-based compensation and suggested using RVUs as “an incentive program” for more-seasoned providers.
Dr. Charles Grim, Health Services deputy executive director, said the organization employs 250 providers, of which 160 are physicians and mid-level providers, at all of CN’s health facilities.
Davis said in a Sept. 11 Health Committee meeting that the Health Services turnover rate is 12 percent compared to the nationwide rate of 14 percent. She also said that in the past year Health Services has lost nine full-time physicians, 11 PRNs or “as needed” workers, five advanced practice registered nurses, two physician assistants and one certified registered nurse anesthetist.
A Government Records Act request submitted by Tribal Councilor David Walkingstick states that in the past six years, 104 providers have left Health Services.
Davis said Human Resources conducts exit interviews for providers who leave and that Health Services officials have not seen the information from those interviews. However, Davis said no one leaving the department has cited to her that compensation was their reason for leaving.
“No one has said, ‘I’m not making enough money. I’m leaving,’ and left. Thankfully,” Davis said.
In light of Health Services being left out of the exit interview process, Tribal Councilor Joe Byrd suggested sending “upper level” staff to sit in on the interviews. “I think if you just let HR take care of it, they really don’t know what they have contributed to the tribe. That’s just a suggestion.”