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    Home > Provider Compensation and Production Glossary

    Academic Status

    Academic: An organization whose majority owner is a university, or their organization type is a medical school or university hospital.
    Non-Academic: An organization whose majority owner is not a university, and their organization type is not a medical school or a university hospital.
     

    Accountable Care Organization 

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    A group of coordinated health care providers who form a healthcare organization characterized by a payment and care delivery model that seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for their population of patients. The ACO is accountable to patients and the third-party payer for the quality, appropriateness, and efficiency of the care provided. 
     

    Advanced Practice Provider (APP)
    Also referred to as: Advanced practice practitioners, nonphysician providers (NPPs), physician extenders, mid-levels, etc.

    Advanced practice providers are specially trained and licensed providers who can provide medical care and billable services. Examples of advanced practice providers include audiologists, certified registered nurse anesthetists (CRNAs), dieticians/nutritionists, midwives, nurse practitioners, occupational therapists, optometrists, physical therapists, physician assistants, psychologists, and surgeon assistants.

    Note: Residents are not considered advanced practice providers in the MGMA data sets.
     

    Advanced Practice Provider to Physician Ratio

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    The practice’s ratio of advanced practice providers to physicians.

    • Physicians only

    • Fewer than one APP per Physician

    • One or more APPs per Physician


    ​​Clinical Full Time Equivalent (FTE) Also referred to as: cFTE

    A measure based upon the number of hours worked on clinical activities for each provider. A provider cannot be more than 1.0 FTE but may be less. For example, a physician administrator who is 80 percent clinical and 20 percent administrative would be 0.8 clinical FTE; a physician with a normal workweek of 32 hours (4 days) working in a clinic or hospital for 32 hours would be a 1.0 clinical FTE; a physician with a normal workweek of 50 hours (5 days) working 32 clinical or hospital hours would be a 0.64 clinical FTE (32 divided by 50 hours).


    Compensation Plan

    • % of Total Compensation Based on On-Call Compensation: Compensation based on “on-call” time.

    • % of Total Compensation Based on Productivity or Equal Share of Compensation Pool: Productivity measures volume of physician work RVUs, collections, etc. This also includes equal share of compensation pool. A “compensation pool” is equal to the total practice revenues net of practice overhead expenses. Such plans generally treat practice overhead as a cost of doing business that is borne by the group as a whole and not allocated to individual physicians (with the potential exception of physician-specific direct expenses). Such plans may be referred to as “team” or “group-oriented” compensation methods. The production metric is measured on the individual physician’s output level.

    • % of Total Compensation Based on Quality and Patient Experience Metrics: Examples of quality measures include, but are not limited to, clinical process/effectiveness, patient safety, care coordination, patient and family engagement, efficient use of healthcare resources, population/public health and patient satisfaction.

    • % of Total Compensation Based on Straight/Base Salary: Compensation is a fixed, guaranteed salary.

    • % of Total Compensation Based on Other Compensation Metrics: A compensation plan metric that is not listed here (medical directorship stipend, honoraria, etc.).


    Compensation Pool

    A “compensation pool” is equal to the total practice revenues net of practice overhead expenses. Such plans generally treat practice overhead as a cost of doing business that is borne by the group as a whole and not allocated to individual physicians (with the potential exception of physician-specific direct expenses). Such plans may be referred to as “team” or “group- oriented” compensation methods. The production metric is measured on the individual physician’s output level.


    Demographic Classification

    • Metropolitan Area (50,000 or More): The county in which the practice is located is defined as a metropolitan (metro) county by the Office of Management and Budget (OMB), based on recent Census Bureau data.

    • Nonmetropolitan Area (49,999 or Fewer): The county in which the practice is located is defined as a nonmetropolitan (nonmetro) county by the Office of Management and Budget (OMB), based on recent Census Bureau data.


    Demographic Classification (Expanded) 

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    • Metro - Counties in metro areas of fewer than 250,000 population: The county in which the practice is located is a Census Bureau defined urbanized area with a population less than 250,000.

    • Metro - Counties in metro areas of 250,000 to 1 million population: The county in which the practice is located is a Census Bureau defined urbanized area with a population of 250,001 to 1,000,000.

    • Metro - Counties in metro areas of 1 million population or more: The county in which the practice is located is a Census Bureau defined urbanized area with a population of 1,000,001 or more.

    • Nonmetro - Completely rural or less than 2,500 urban population: The county in which the practice is located is referred to as “rural.” It may or may not be adjacent to a metropolitan area and has a population less than 2,500.

    • Nonmetro - Urban population of 2,500 to 19,999: The county in which the practice is located is referred to as “rural.” It may or may not be adjacent to a metropolitan area and has a population between 2,500 and 19,999.

    • Nonmetro - Urban population of 20,000 or more: The county in which the practice is located is referred to as “rural.” It may or may not be adjacent to a metropolitan area and has a population of 20,000 or more.


    Faculty Rank 

    Picture2.pngAcademic Compensation Data Set

    The highest academic rank held by the faculty physician.

    Included:

    • Instructor
    • Assistant Professor
    • Associate Professor
    • Professor
    • Division Chair/Chief
    • Non-Faculty

    Not included:

    Itinerary volunteers or commissioned physicians who teach; or
    Fellows


    Federally Qualified Health Center (FQHC)

    A reimbursement designation that refers to several health programs funded under Section 330 of the Public Health Service Act of the US Federal Government.

    These 330 grantees in the Health Center Program include:

    • Community Health Centers which serve a variety of underserved populations and areas;

    • Migrant Health Centers which serve migrant and seasonal agricultural workers;

    • Health Care for the Homeless Programs which reach out to homeless individuals and families and provide primary and preventive care and substance abuse services; and

    • Public Housing Primary Care Programs that serve residents of public housing and are located in or adjacent to the communities they serve.

    • FQHCs are community-based organizations that provide comprehensive primary and preventive health, oral, and mental health/substance abuse services to persons in all stages of the life cycle, regardless of their ability to pay.


    Fiscal Year

    The corporate year established by the practice for business purposes. For many practices, this is January through December of the same year. The data reported is representative of the completed fiscal year.


    Freestanding Ambulatory Surgery Center (ASC)

    A freestanding entity that is specifically licensed to provide surgery services that are performed on a same-day outpatient basis. A freestanding ambulatory surgery center does not employ physicians. They are not eligible for this report.


    Full Time Equivalent (FTE)

    A measure based upon the number of actual hours worked regardless of whether it’s spent in clinical or nonclinical activities. A 1.0 FTE provider works the number of hours the practice considers to be the minimum for a normal workweek, which could be 37.5, 40, 50 hours, or some other standard. Regardless of the number of hours worked, a provider cannot be counted as more than 1.0 FTE.


    Geographic Section


     

    Eastern Section:

    Connecticut
    Delaware
    District of Columbia
    Maine
    Maryland
    Massachusetts
    New Hampshire
    New Jersey
    New York
    North Carolina
    Pennsylvania
    Rhode Island
    Vermont
    Virginia
    West Virginia

    Western Section:

    Alaska
    Arizona
    California
    Colorado
    Hawaii
    Idaho
    Montana
    Nevada
    New Mexico
    Oregon
    Utah
    Washington
    Wyoming

     

    Midwest Section:

    Illinois
    Indiana
    Iowa
    Michigan
    Minnesota
    Nebraska
    North Dakota
    Ohio
    South Dakota
    Wisconsin

    Southern Section:

    Alabama
    Arkansas
    Florida
    Georgia
    Kansas
    Kentucky
    Louisiana
    Mississippi
    Missouri
    Oklahoma
    South Carolina
    Tennessee
    Texas


    Health and Human Services (HHS) Regions 

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    HHS Region 1:

    Connecticut
    Maine
    Massachusetts
    New Hampshire
    Rhode Island
    Vermont

    HHS Region 2:

    New Jersey
    New York

    HHS Region 3:

    Delaware
    District of Colombia
    Maryland
    Pennsylvania
    Virginia
    West Virginia

    HHS Region 4:

    Alabama
    Florida
    Georgia
    Kentucky
    Mississippi
    North Carolina
    South Carolina
    Tennessee

    HHS Region 5:

    Illinois
    Indiana
    Michigan
    Minnesota
    Ohio
    Wisconsin

    HHS Region 6:

    Arkansas
    Louisiana
    New Mexico
    Oklahoma
    Texas

    HHS Region 7:

    Iowa
    Kansas
    Missouri Nebraska

    HHS Region 8:

    Colorado
    Montana
    North Dakota
    South Dakota
    Utah
    Wyoming

    HHS Region 9:

    Arizona
    California
    Hawaii
    Nevada

    HHS Region 10:

    Alaska
    Idaho
    Oregon
    Washington


    Hired Out of Residency or Fellowship 

    Picture5-(1).pngProvider Placement Starting Salary Data Set

    Fellow: A physician who has completed training as a resident and has been granted a position allowing him or her to do further study or research in a specialty.
    Residency: A period of advanced medical training and education that normally follows graduation from medical school and licensing to practice medicine. This process consists of supervised practice of a specialty in a hospital and in its outpatient department and instruction from specialists on the hospital staff.


    Internal or External Directorship

    Picture5-(1).pngMedical Directorship Data Set

    External Directorship: A directorship is considered external if a different federal tax ID is used for the provider’s clinical work and directorship duties. For example, if the physician is employed by a medical director for an organization other than the one he or she practices at, the directorship would be considered "External".
    Internal Directorship: A directorship is considered internal if the same federal tax ID is used for the provider’s clinical work and directorship duties. For example, if the physician is employed by his medical practice for his medical directorship duties, the directorship would be considered "Internal".


    Legal Organization

    Business Corporation: A for-profit organization recognized by law as a business entity separate and distinct from its shareholders. Shareholders need not be licensed in the profession practiced by the corporation.
    Limited Liability Company (LLC): A legal entity that is a hybrid between a corporation and a partnership, because it provides limited liability to owners like a corporation while passing profits and losses through to owners like a partnership.
    Not-for-profit Corporation/Foundation: An organization that has obtained special exemption under Section 501(c) of the Internal Revenue Service code that qualifies the organization to be exempt from federal income taxes. To qualify as a tax exempt organization, a practice or faculty practice plan would have to provide evidence of a charitable, educational, or research purpose.
    Partnership: An unincorporated organization where two or more individuals have agreed that they will share profits, losses, assets, and liabilities, although not necessarily on an equal basis. The partnership agreement may or may not be formalized in writing.
    Professional Corporation/Association: A for-profit organization recognized by law as a business entity separate and distinct from its shareholders. Shareholders must be licensed in the profession practiced by the organization.
    Sole Proprietorship: An organization with a single owner who is responsible for all profit, losses, assets, and liabilities


    Loan Forgiveness Amount 

    Picture5-(1).pngProvider Placement Starting Salary Data Set

    The dollar value the provider receives as loan forgiveness in his or her contract.
     

    Medical Records Storage System

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    The method in which the practice stored health/medical records for the majority of patients served by the practice.
     

    Medical School 

    Picture2.pngAcademic Compensation Data Set

    A medical school is an institution that trains physicians and awards medical and osteopathic degrees.


    Medical-School-Sponsored Program

    Picture2.pngAcademic Compensation Data Set

    The program is accredited by the Accreditation Council of Graduate medical Education (ACGME), is a direct branch of a university medical school, and staffed with university faculty.


    Minor Geographic Region 

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    Northeast Region:

    Connecticut
    Maine
    Massachusetts
    New Hampshire
    Rhode Island
    Vermont

    North Atlantic:

    New Jersey
    New York
    Pennsylvania

    Northwest:

    Idaho
    Oregon
    Washington

    Mid Atlantic:

    Delaware
    District of Columbia Maryland
    Virginia
    West Virginia

    Southeast:

    Alabama
    Florida
    Georgia
    Mississippi
    North Carolina South Carolina Tennessee

    Eastern Midwest:

    Illinois
    Indiana
    Kentucky
    Michigan
    Ohio

    Upper Midwest:

    Iowa
    Minnesota
    Nebraska
    North Dakota
    South Dakota
    Wisconsin

    Lower Midwest:

    Arkansas
    Kansas
    Louisiana
    Missouri Oklahoma
    Texas

    Rocky Mountain:

    Arizona
    Colorado
    Montana
    Nevada
    New Mexico
    Utah

    Pacific:

    Alaska
    California
    Hawaii


    Number of FTE Advanced Practice Providers 

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    The practice's full-time-equivalent (FTE) advanced practice provider count. For further detail on FTE or Advanced Practice Providers, see corresponding definitions.

    • No advanced practice providers

    • 3 or fewer

    • 4 to 9

    • 10 or more


    Number of FTE Advanced Practice Providers (expanded) 

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    The practice's full-time-equivalent (FTE) advanced practice provider count. For further detail on FTE or Advanced Practice Providers, see corresponding definitions.

    • 3 or fewer

    • 4 to 6

    • 7 to 10

    • 11 to 25

    • 26 to 50

    • 51 to 75

    • 76 to 150

    • 151 or more


    Number of FTE Physicians

    The practice's full-time-equivalent (FTE) physician count. For further detail on FTE, see Full-Time Equivalent above.

    • 6 or fewer

    • 7 to 10

    • 11 to 25

    • 26 to 50

    • 51 to 75

    • 76 to 150

    • 151 or more


    Number of FTE Physicians (expanded) 

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    The practice's full-time-equivalent (FTE) physician count. For further detail on FTE, see Full-Time Equivalent above.

    • 3 or fewer

    • 4 to 6

    • 7 to 10

    • 11 to 25

    • 26 to 50

    • 51 to 75

    • 76 to 150

    • 151 or more


    Number of Total FTE Faculty 

    Picture2.pngAcademic Compensation Data Set

    The practice's full-time-equivalent (FTE) faculty count. For further detail on FTE or Providers, see corresponding definitions.

    • 10 or fewer

    • 11 to 25

    • 26 to 50

    • 51 to 100

    • 101 to 150

    • 151 or more


    Number of FTE Support Staff 

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    The practice’s total support staff FTE including business operations staff, front office support staff, clinical support staff, ancillary support staff, and contracted support staff.

    • No support staff

    • 3 or fewer

    • 4 to 9

    • 10 or more


    Number of FTE Support Staff (expanded)

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    The practice’s total support staff FTE including business operations staff, front office support staff, clinical support staff, ancillary support staff, and contracted support staff.

    • 3 or fewer

    • 4 to 6

    • 7 to 10

    • 11 to 25

    • 26 to 50

    • 51 to 75

    • 76 to 150

    • 151 to 250

    • 251 to 500

    • 501 or more


    Organization Ownership

    Hospital/IDS Owned:

    • Hospital: A hospital is an inpatient facility that admits patients for overnight stays, incurs nursing care costs, and generates bed-day revenues.

    • Integrated Health System or Integrated Delivery System (IDS): A network of organizations that provide or coordinate and arrange for the provision of a continuum of health care services to consumers and is willing to be held clinically and fiscally responsible for the outcomes and the health status of the populations served. Generally consisting of hospitals, physician groups, health plans, home health agencies, hospices, skilled nursing facilities, or other provider entities, these networks may be built through “virtual” integration processes encompassing contractual arrangements and strategic alliances as well as through direct ownership.

    • Management Services Organization (MSO): An entity organized to provide various forms of practice management and administrative support services to health care providers. These services may include centralized billing and collections services, management information services, and other components of the managed care infrastructure. MSOs do not actually deliver health care services. MSOs may be jointly or solely owned and sponsored by physicians, hospitals, or other parties. Some MSOs also purchase assets of affiliated physicians and enter into long-term management service arrangements with a provider network. Some expand their ownership base by involving outside investors to help capitalize the development of such practice infrastructure.

    • Physician Practice Management Company (PPMC): Publicly held or entrepreneurial directed enterprises that acquire total or partial ownership interests in physician organizations. PPMCs are a type of MSO, however their motivations, goals, strategies, and structures arising from their unequivocal ownership character – development of growth and profits for their investors, not for participating providers – differentiate them from other MSO models.

    Physician Owned:

    • Advanced Practice Providers: Any advanced practice provider (e.g. nurse practitioners, physical therapists, etc.) duly licensed and qualified under the law of jurisdiction in which treatment is received.

    • Physicians: Any Doctor of Medicine (MD) or Doctor of Osteopathy (DO) who is duly licensed and qualified under the law of jurisdiction in which treatment is received.

    Other Majority Owner:

    • Insurance Company or Health Maintenance Organization (HMO): An insurance company that accepts responsibility for providing and delivering a predetermined set of comprehensive health maintenance and treatment services to a voluntarily enrolled population for a negotiated and fixed periodic premium. An organization that indemnifies an insured party against a specified loss in report for premiums and paid as stipulated by a contract.

    • Government: A governmental organization at the federal, state, or local level. Government funding is not enough criterion. Government ownership is the key factor. An example would be a medical clinic at a federal, state, or county correctional facility.

    • Private Investor(s): A company or individual that takes their own money and uses it to fund another organization. Some investors have the option to invest passively, which means they give their funding and play no further role, while others have a more significant role in the organization.

    • University or Medical School: An institution of higher learning with teaching and research facilities comprising undergraduate, graduate and professional schools. A medical school is an institution that trains physicians and awards medical and osteopathic degrees.


    Patient Care Revenue

    Picture2.pngAcademic Compensation Data Set

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    In general, all revenue received by the department from patient care activities, net of all refunds, returned checks, contractual discounts and allowances, bad debts and write-offs. The sum of total fee-for service (FFS) revenue, net prepaid (capitation/subcapitation) revenue and net other patient care/medical services revenue equals total patient care revenue.

    Net Prepaid (Capitation/Sub-Capitation) Revenue: A sum of all capitation revenue received from Health Maintenance Organizations (HMOs), risk-sharing revenue, hospital/utilization withholds, co-payments and revenue received from a benefits coordination and/or reinsurance recovery situation minus professional and medical services purchased from outside providers.

    Net Other Patient Care/Medical Services Revenue: A sum of all revenue received from the sale of goods and services such as durable medical equipment rental, revenue from medical service contracts with nursing homes or ambulatory care centers, hospital reimbursements for direct patient care, and revenue from providing ancillary services on a fixed fee or percentage contract that are not billed as fee-for-service.

    Total FFS Revenue: A sum of net collections (receipts) from patients who are self-insured, or reimbursements from a third party insurer that compensates the department (practice plan) on a fee-for-service, or discounted fee-for service basis. 
     

    Patient Centered Medical Home (PCMH) 

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    A care delivery model where patient treatment and care is coordinated through their primary care provider to ensure they receive high quality care when care is necessary. The objective is collaboration between the patient and physicians with care delivered in a way the patient can understand. PCMHs seek to improve the quality, effectiveness, and efficiency of the care delivered while focusing on meeting patient needs first.
     
    Physician Work Hours Allocation <Help Menu: Additional Data Tables>
    The percentage of a physician’s total work hours allotted to billable clinical, administrative, teaching, research and/or other work.

    % Administrative: Administrative percent can be calculated a variety of ways. In general, the calculations are all the same – the clinical effort divided by the total effort. Often, the difference between formulas equals the units of measurement, such as hours per day or sessions per week. Administrative effort includes medical directorships as well as other administrative duties.

    % Billable Clinical: Those activities performed by the physician in which patients are seen in the office, outpatient clinic, emergency room, nursing home, operating room, or labor and delivery; any time spent on hospital rounds, telephone conversations with patients, consultations with providers, interpretation of diagnostic tests, and chart review. This should also include “on-call” hours if the provider is required to be present in the medical facility, such as a medical clinic or hospital.
    Billable clinical percent can be calculated a variety of ways. In general, the calculations are all the same — the clinical effort divided by the total effort. Often, the difference between formulas equals the units of measurement, such as hours per day or sessions per week. Clinical effort and activities include direct patient care and consultation, individually or in a team-care setting, where a patient bill is generated, or a fee-for-service equivalent charge is recorded.

    % Research: Measures used by the department to track productivity of research efforts. The time the provider spent in research activities. For example, a faculty member spending approximately 30 percent of his/her time in research activities should report “30.”

    Included:

    • Research activities including specific research, training, and other projects that are separately budgeted and accounted for by the medical school; and

    • Clinical research funded or nonfunded.

    % Teaching: Measures used by the department to track effectiveness and/or productivity of teaching efforts. The percent of time the provider spent in teaching activities such as classroom time, office hours, grading papers, and class preparation. For example, a faculty member spending approximately 40 percent of his/her time in teaching activities should report “40.”

    Included:

    • Academic activities including teaching, tutoring, lecturing, and supervision of laboratory course work and residents where patient care is not provided; and

    • Nonclinical classroom time.

    % Other: Other percent can be calculated a variety of ways. In general, the calculations are all the same - the clinical effort divided by the total effort. Often, the difference between formulas equals the units of measurement, such as hours per day or sessions per week. Other effort and activities include all activities not included in clinical, administrative, teaching or research effort, such as professional development.
     

    Practice Type

    Multispecialty: A medical practice that consists of physicians practicing in different specialties.

    Single Specialty: A medical practice that focuses its clinical work in one specialty. The determining factor for classifying the type of specialty is the focus of clinical work and not necessarily the specialties of the physicians in the practice.
     

    Practice Type (Expanded) 

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    Multispecialty: A medical practice that consists of physicians practicing in different specialties.

    • Multispecialty with Primary and Specialty Care: Medical practices that consist of physicians practicing in different specialties, including at least one primary care specialty listed below:

      • Family Medicine: General
      • Family Medicine: Sports Medicine
      • Family Medicine: Urgent Care
      • Family Medicine: With Obstetrics
      • Family Medicine: Without Obstetrics
      • Geriatrics
      • Internal Medicine: General
      • Pediatrics: Adolescent Medicine
      • Pediatrics: General
      • Pediatrics: Sports Medicine
      • Urgent Care
    • Multispecialty with Primary Care Only: A medical practice that consists of physicians practicing in more than one of the primary care specialties listed above or one of the specialties below:

      • Obstetrics/gynecology
      • Gynecology (only)
      • Obstetrics(only)
    • Multispecialty with Specialty Care Only: A medical practice that consists of physicians practicing in different specialties, none of which are the primary care specialties listed above

    • Single Specialty: A medical practice that focuses its clinical work in one specialty. The determining factor for classifying the type of specialty is the focus of clinical work and not necessarily the specialties of the physicians in the practice.
       

    Production Bonus Amount

    Picture5-(1).pngProvider Placement Starting Salary Data Set

    The dollar value the provider was offered as a bonus based on his or her production during the first year.
     

    Provider FTE Category 

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    The provider's full-time-equivalent (FTE) category. For further detail on FTE, see Full-Time Equivalent above.

    • 0.30 to 0.40                      • 0.70 to 0.75

    • 0.40 to 0.50                      • 0.75 to 0.80

    • 0.50 to 0.55                      • 0.80 to 0.85

    • 0.55 to 0.60                      • 0.85 to 0.90

    • 0.60 to 0.65                      • 0.90 to 0.95

    • 0.65 to 0.70                      • 0.95 to 1.00


    Provider had Supervisory Duties

     Picture6.pngProvider Compensation Data Set

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    Whether or not a provider had supervisory duties or not in their practice.


    Relocation of Placement

    Picture5-(1).pngProvider Placement Starting Salary Data Set

    The state from which the provider relocated. If the provider was relocated from outside of the United States, “Out of Country” was indicated.
     

    Rural Health Clinic (RHC)

    A clinic certified to receive special Medicare and Medicaid reimbursement. The purpose of the RHC program is to improve access to primary care in underserved rural areas. RHCs are required to use a team approach of physicians and advanced practice providers (nurse practitioners, physician assistants, and certified nurse midwives) to provide services. The clinic must be staffed at least 50% of the time with an advanced practice provider. RHCs may also provide other healthcare services such as mental health or vision services, but reimbursement for those services may not be based on their allowable cost.


    Signing Bonus Offered 

    Picture5-(1).pngProvider Placement Starting Salary Data Set

    Whether or not a provider was offered a signing bonus as part of the contract offer or negotiation.


    Signing Bonus Payback Required 

    Picture5-(1).pngProvider Placement Starting Salary Data Set

    Full Payback: Full payback of the signing bonus from the provider to the practice.
    Prorated Payback: A prorated amount of the signing bonus.
    Not Required: The provider is not required to pay back the signing bonus.


    Starting Bonus Offered

    Picture5-(1).pngProvider Placement Starting Salary Data Set

    Whether or not a provider was offered a starting bonus as part of the contract offer or negotiation.


    Tail Coverage Amount 

    Picture5-(1).pngProvider Placement Starting Salary Data Set

    The dollar value of tail coverage offered to the provider in his or her contract.


    Technical Component (TC)

    Modifier-TC, when attached to an appropriate CPT code, represents the technical component of the procedure and includes the cost of equipment and supplies to perform that procedure. This modifier corresponds to the equipment/facility part of a given procedure.

    • Collections for professional charges and gross charges for laboratory, radiology, medical diagnostic and surgical procedures may have two components: the physician’s professional charge such as interpretation and the technical charge for the operation and use of the equipment. If collections for professional charges and gross charges did not include the technical component (TC), referred to as professional services only billing, that would be considered “0% TC.” If collections for professional charges and gross charges did include the technical component, referred to as global fee billing, we provide approximate percentage of charges represented by the technical component, which will be either “1-10%” or “greater than 10%.


    Telehealth services 

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    Whether or not a practice offered telehealth services to their patients.


    Total Medical Revenue

    The sum of fee-for-service collections (revenue collected from patients and third-party payers for services provided to fee-for service, discounted fee-for-service, and non-capitated Medicare/Medicaid patients), capitation payments (gross capitation revenue minus purchased services for capitation payments), and other medical activity revenues.

    • Net Prepaid (Capitation/Sub-Capitation) Revenue: Includes all capitation revenue received from Health Maintenance Organizations (HMOs), risk-sharing revenue, hospital/utilization withholds, co-payments and revenue received from a benefits coordination and/or reinsurance recovery situation minus professional and medical services purchased from outside providers.

    • Net Other Patient Care/Medical Services Revenue: Includes all revenue received from the sale of goods and services such as durable medical equipment rental, revenue from medical service contracts with nursing homes or ambulatory care centers, hospital reimbursements for direct patient care, and revenue from providing ancillary services on a fixed fee or percentage contract that are not billed as fee-for-service.

    • Other Medical Revenue: Includes grants, honoraria, research contract revenues, government support payments, and educational subsidies plus the revenue from the sale of medical goods and services.

    • Total Department Revenue: All revenue received by the department from patient care activities, net of all refunds, returned checks, contractual discounts and allowances, bad debts and write-offs. The sum of total fee-for-service (FFS) revenue, net prepaid (capitation/sub-capitation) revenue and net other patient care/medical services revenue equals total patient care revenue.

    • Total FFS Revenue: Includes net collections (receipts) from patients who are self-insured, or reimbursements from a third-party insurer that compensates the department (practice plan) on a fee-for-service, or discounted fee-for service basis.


    Type of Compensation Tax Form

    The form (W2, K1, 1099) used to report employee wages.


    Type of On-Call Coverage Provided 

    Picture4.pngOn-Call Data Set

    Both Restricted/Unrestricted: A type of on-call coverage in which the provider must be present at the facility for part of the additional block and is available to respond to pages, as necessary, for the other part of his or her coverage.

    General ED Call: The provider must only be available for general emergency department call while providing on-call coverage.

    Restricted: A type of on-call coverage in which the provider must be present at the facility throughout the additional block.

    Trauma Call—Level 1: The provider must only be available for emergency trauma call while providing on-call coverage.

    Trauma Call—Level 2: The provider must only be available for emergency trauma call while providing on-call coverage.

    Trauma Call—Level 3: The provider must only be available for emergency trauma call while providing on-call coverage.

    Trauma Call—Level 4: The provider must only be available for emergency trauma call while providing on-call coverage.

    Unrestricted: A type of on-call coverage in which the provider must be available to respond to pages as necessary. Also referred to as "beeper only" coverage.

    Other Call: Coverage outside of those listed above


    Work Status 

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    • Full-Time 0.75 – 1.0 FTE and ≥ 75% billable clinical

    • Part-Time 0.35 – 0.75 FTE and ≥ 75% billable clinical

    • Partially Clinical 0.75 – 1.0 FTE and 35% - 75% billable clinical


    Years in Specialty

    The number of years the physician or advanced practice provider has practiced in the specialty reported. The count of the number of years begins at the time the physician completes the latter of the residency or fellowship.
     


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