RVU Salary Model Sets Up Cardiothoracic Surgeons to Fail

Ask Michael G. Moront, MD if a Relative Value Unit-based productivity employment model is good for cardiothoracic surgeons, and he will tell you no.

For Dr. Moront, an RVU model spurs internal practice competition, discourages the addition of new partners, encourages patient hoarding, and does not pay for services that do not fit a medical billing model, such as attending hospital meetings and spending nights sitting by a patient’s bedside.

During Sunday’s Practice Management Summit, he shared how he and his colleagues at Cardiothoracic Surgeons of Northwest Ohio, Promedica Health System, changed from RVU- to salary-based employment contracts.

“Hospitals are very concerned about paying physicians fair market value. They need a number to hang their hats on, and they can calculate that number with RVUs,” said Dr. Moront, Director of Cardiothoracic Surgical Research at Toledo Hospital.

“It was great when things were good. For the most part, we were pretty happy. At first, we got raises and bonuses,” Dr. Moront said. “But then, hospital administrators made decisions that negatively affected 15%-18% of our cardiology referrals, and our salaries fell. The hospitals had no stake in our salaries. We as a group recognized internal group competition caused by the work RVU employment model and wanted to get off the ‘wRVU treadmill.’”

The cardiothoracic surgery group had worked to grow the practice, performing more than 900 heart surgeries each year at two hospitals.

Wanting a new employment model that shared risks and addressed the problems with a wRVU-based agreement, the surgeons went to hospital administrators and were able to lock into a 5-year salary-based contract.

“We’re 2 years into our new contract, and we’re all happy with it,” said Dr. Moront, adding that the new employment model has provided his group with a degree of security in a competitive medical environment, allowing the group to work more cohesively with the hospital.