Besides dealing with the decrease in “elective” surgeries, shortage of PPE supplies, increased acuity of patients, and financial toxicity through the roof, physicians are struggling with their own financial realities. One of the many questions we’re fielding relates to the stimulus funds received last month. How are funds, if any, allocated between the technical owner and physician when the center employs the radonc or bills globally?
This is new territory, and, like most things of late, we are without much guidance. As center owners, we’re in the same situation and faced with the same issues. Here is our rationale, perhaps it will help in your case.
- A rising tide lifts boats (or the tide lowers all boats!). Hospital/technical owners and physicians need each other and cannot exist without a symbiotic relationship.
- The stimulus was calculated on past REVENUE generated from treating patients.
- Patient revenue is captured by CPT nomenclature.
- CPT codes have professional and technical components.
- Apply the Professional percentage in the Professional Service Agreement (PSA) to funds.
- Or, calculate the past 90 days’ CPT technical to professional RVU utilization percent and apply that percent to allocate the funds.
Most percentage-based PSAs and actual tech/pro CPT reviews range from 15-21% professional. At our centers, we pay our physician owners 21% of all funds received globally, so we used the same percentage against the stimulus funds. One could argue that the hospital/technical owner bears the extra cost of PPE supplies. One could also argue the physician leadership and time cost to exposure are greater. There are no CMS guidelines or legal precedent. This is one of those times when we are all in it together, and we have chosen to err toward physicians and collaborative sharing.
Action needed – 1. Most importantly, we need to know how your funds were allocated. We are collecting stimulus allocation across the nation and need your input. We will provide a summary back to everyone that participates. Your input may very well be the justification for another colleague! 2. We will be glad to help you calculate your allocation and represent you at the table within your department/hospital.
Call us at 615-746-1705 or contact us if we can assist.
My best,
Chief Executive Officer
Radiation Business Solutions
