Calculating Physician Assistant workRVU Bonus
A common way to track productivity of medical providers is to look at workRVUs; compared to other methods this can be confusing. If you are compensated based on workRVUs there are a lot of numbers to keep track of, and it takes doing some math to figure out where you’re at.
The first number you want to look at is the workRVUs you’re generating; the second number to look at is how many dollars you are compensated per workRVU. To help better explain this I’ll go through an example of how and what you’d be calculating.
Estimate for Annual WorkRVU
Using estimates for how many patients are seen in a year we’ll figure out how many workRVUs one may be generating. Let’s say you work in primary care and see about 16 patients a day and work 5 days a week.
For simplicity we will say you average a 99213 visit, a basic follow up. For a 99213 you would get .97 workRVUs. If you see 16 patients per day multiplied by 5 days in a week that would equate to 80 patients a week, multiple this by 47 weeks (52 weeks in a year minus 4 weeks for vacation and 1 for CME to attend the AAPA conference) and you would have seen 3,760 patients in a year. To calculate total workRVU for the year you would multiply your visits by .97 workRVU and you would be generating 3,648 workRVU per year.
Now that we know how many workRVU you may be generating in a year the next step would be to put a dollar amount to it. Usually there is a tiered system, and as you reach more workRVUs you earn more dollars per workRVU. For example from 0 to 2,000 workRVU you would be compensated $30 per workRVU, from 2,000 to 4,000 workRVU you’re compensated $35 per workRVU and for anything above 4,000 workRVU you get compensated $40 per workRVU.
The above example is theoretical, but is how a tiered system would work; often there are two to four different tiers. I’ve heard the compensation per workRVU ranging anywhere from $30 – $40 per workRVU, and is based on factors such as region of the country you work, types of patients you see and other external factors. You most likely will be given a base salary and once you attain a certain level of workRVUs, you’d be given a bonus based on how many workRVUs you have generated. I’ve heard of bonuses given out monthly, quarterly or annually.
Where RVU Compensation Data Comes From
Where do all these number come from? The group that you work for most likely gets numbers from a consulting company like Sullivan and Cotter who collects data for the American Medical Group Association (AMGA) on compensation and benefits for providers of medical groups. The Medical Group Management Association (MGMA) is a similar organization that is often consulted.
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2018 Numbers for WorkRVU Bonus
We now know how to calculate how many workRVUs you are generating, and how to calculate compensation based on workRVU, but what does this look like in real life?
For this example there are only two tiers; and we will use a base salary of $104,000 as this is about average for 2017 , with numbers for primary care in the Northwest. According to Sullivan and Cotter the median annual workRVU is 3424 and for this example bonus is paid quarterly. For the high tier you would have to generate more than 855 workRVU (3424 divided by 4) in a quarter. Compensation per workRVU is $31.90 for tier 1 and $36.90 for Tier 2.
With a base salary of $104,000 the monthly paycheck would be $8,666 which would equal $26,000 quarterly. Bonus is not calculated until you’ve reached your base salary ($26,000 divided by $31.90 would be 815 workRVU); so in order to get a bonus you would need to generate more than 815 workRVU.
We previously calculated generating about 3,648 workRVU per year seeing 16 patients a day. If we divide this into quarters you’d be generating about 912 workRVU a quarter. 912 minus 855 would be 57 workRVU, multiply this by $36.90 (tier 2 compensation) and you would get $2,103.3. Then to figure out tier 1 bonus you would multiply the remaining workRVU over the base amount by $31.90: 855 minus 815 (workRVU for base salary) equals 40, multiplied by $31.90 is $1,276. Your total quarterly bonus would be $1,276 (tier 1 bonus) plus $2,103.3 (tier 2 bonus), $3,379.3.
If you were seeing more patients than 16 per day, or your typical patient is more complex than a level 3 follow up, you would be generating more workRVU than we have calculated. Your office might be using more than two tiers which would also change the calculations some. Also, the median workRVU can vary depending on specialty; orthopedics is going to be much different than family medicine.
This compensation model is not just for PAs; Physicians and Nurse practitioners are also compensated on similar models, but with different numbers for median workRVU and dollar per RVU. However, workRVUs for visit type is the same for everyone, a level 3 follow up is .97 workRVU if you’re a PA, NP or Physician.
Understand How Your PA Compensation is Calculated
Again worth noting is that this compensation model is only fair if all work performed by the PA is attributed to the PA. If your company bills out shared visits or incidence-to than this type of compensation model will not work. Also, it is important that you receive a copy of the data reports, so you know what you’re generating and can see how your bonus is being calculated. You can’t expect to reach a bonus if you don’t know how it is calculated or what the numbers are to reach it.
It is important to understand where the numbers come from if you are compensated based on workRVUs. The example in this post was based on primary care and used actual dollar amounts that I’ve seen for 2018. It is important to compare apples to apples, so if you’re working in a specialty you would need to use the median workRVU for your specialty. Once you know how many workRVU you are generating, and how you compare to others you can use that to help you negotiate a higher salary in the future.
Are you compensated based on workRVU? How does your dollar per RVU and median RVU number compare to above? Is your bonus calculation more straight forward? Don’t forget to sign up to receive future posts by email, please comment below the original post and share with your friends!
