College of Medicine Faculty Development Workshop - PowerPoint Presentation

1. College of MedicineFaculty Development WorkshopWhere Does My Salary Come From?Neil Holsing, MBAAssociate Dean of Operations

2. Where Does My Salary Come From?Neil Holsing, MBAOctober 1, 2019Learning ObjectivesAt the end of this course, participants should be able to:Identify various Funding SourcesReview how Benchmarks are utilizedDiscuss the basics of UCP Compensation PlanExplain the role of the Compensation CommitteeTarget AudiencePhysicians, graduate students, College of Medicine staff, residents, fellows, any/all University employees.

3. DisclosuresSpeaker DisclosureIn accordance with the ACCME Standards for Commercial Support of CME, the speakers for this course have been asked to disclose to participants the existence of any financial interest and/or relationship(s) (e.g., paid speaker, employee, paid consultant on a board and/or committee for a commercial company) that would potentially affect the objectivity of his/her presentation or whose products or services may be mentioned during their presentation. The following disclosures were made:Planning Committee Members:Alex B. Lentsch, PHD, Course Director –No Relevant RelationshipsDawn O. Kleindorfer, MD – No Relevant RelationshipsAngela Doud - Coordinator – No Relevant RelationshipsBrandon Armstrong, CME Program Coordinator – No Relevant RelationshipsSpeakerNeil Holsing, MBA - No Relevant Relationships

4. DisclosuresOff-Label Disclosure Statement Faculty members are required to inform the audience when they are discussing off-label, unapproved uses of devices and drugs. Physicians should consult full prescribing information before using any product mentioned during this educational activity.Learner Assurance Statement The University of Cincinnati is committed to resolving all conflicts of interest issues that could arise as a result of prospective faculty members’ significant relationships with drug or device manufacturer(s). The University of Cincinnati is committed to retaining only those speakers with financial interests that can be reconciled with the goals and educational integrity of the CME activity. Accreditation Statement for Directly Sponsored Activity The University of Cincinnati is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.The University of Cincinnati designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Disclaimer Statement The opinions expressed during the live activity are those of the faculty and do not necessarily represent the views of the University of Cincinnati. The information is presented for the purpose of advancing the attendees’ professional development.

5. What needs to be covered?Funding sources must cover salary and fringe benefitsUniversity of CincinnatiUC PhysiciansFringe RatePhDMDMDFederal30.0%36.6%N/ANon-Federal31.4%38.6%12.0%Fringe Benefits may include:RetirementVac/Sick TimeLifeRetirementVac/Sick TimeLifeMedical/Dental/VisionFlex SpendingTuition RemissionEmployee Assistance ProgramTravel Assistance ProgramL-T Disability

6. What needs to be covered?Example:University of CincinnatiUC PhysiciansPhDMDMDNon-Federal31.4%38.6%12.0%Salary$100,000$50,000$50,000Fringe Benefit (FB)$31,400$19,300$6,000Salary + FB$131,400$69,300$56,000$100,000$25,300$125,300Funding Sources must cover both salary and fringe benefit costs

7. Funding Sources / EffortFunding Sources largely depends on effort

8. Funding Sources / EffortGeneral expectation is that funding is sufficient to cover effortAny effort without sufficient funding must be covered by other sources; may be cross-subsidization

9. Funding Sources / EffortGeneral expectation is that funding is sufficient to cover effortAny effort without sufficient funding must be covered by other sources; may be cross-subsidization

10. Faculty/Provider Effort$425MSal + FB

11. Funding for Clinical EffortPrimarily billable servicesProfessional fees onlyPayor mix can be problematicUC Health often times provides sustaining funds - $/cFTEContract – i.e., other health systemsVA – often direct compensationOther sources:EndowmentsGifts

12. Funding for Research EffortPrimarily grants/trialsService Centers (Cores)VA – often direct compensationInternal fundingClinical Depts: Funding from UC Health – Quasi or Academic Support Payment (ASP)Basic Science Depts: CoM provides 50% research salary support for basic science departmentsOther sources:EndowmentsGifts

13. Funding for Education EffortMedical Student, Undergrad, Graduate – funded by CoM via General Funds (tuition & state)$2.7M masters – portion of tuition revenue$3.9M block/clerkship directors, curriculum facilitators, content experts, LCFs, PhD & undergrad program directors – AAMC salary benchmark$9.3M medical student teaching - $/contact hr M1/2; $/rotation wk M3/4$1.2M PhD student teaching - $/credit hr$222K undergrad teaching - $/credit hrResident/Fellow funded by UC Health – AAMC salary benchmarkOther sources:CCHMC / VAEndowments/Gifts

14. Funding for Administrative EffortDepartment ChairsUC Health (actual)Endowed Chairs (available funding)Division Chiefs/DirectorsUC Health (AAMC benchmark) – depends on department sizeDepartment fundsMedical DirectorsUC Health (AAMC benchmark)Other health systems (clinical contract)College Roles – CoM/Dean (actual)University Roles – University (actual)Other UC Health Roles – UC Health (actual)ACMO, Epic champion, etc.

15. Funding ExamplesExample of what needs to be covered:University of CincinnatiUC PhysiciansPhDMDMDNon-Federal31.4%38.6%12.0%Salary$100,000$50,000$50,000Fringe Benefit (FB)$31,400$19,300$6,000Salary + FB$131,400$69,300$56,000$100,000$25,300$125,300

16. Funding ExamplesPhD: $131,400 Salary/FBExample is basic science department with 50% research effort salary support from DeanEffort%Needed $sActual Funding ($s)NetClinical0%$0N/A$0$0) Research80%$105,120CoM 50% Research EffortGrant(s) 35% EffortEndowment/Gift$52,560$45,990$10,000$3,430)Education20%$26,280Program Director (CoM)PhD Teaching (CoM)$20,000$5,000($1,280)Administration0%$0N/A$0$0)Total100%$131,400$133,550$2,150)

17. Funding ExamplesMD: $125,300 Salary/FBEffort%Needed $sActual Funding ($s)NetClinical60%$75,180Professional FeesSustaining Funds (UC Health)$55,000$18,000($2,180)Research20%$25,060Clinical Trial(s)Quasi/ASP (UC Health)$15,000$8,110($1,950)Education10%$12,530Block Director 10% (CoM)$15,000$2,470)Administration10%$12,530Medical Director (UC Health)$15,000$2,470)Total100%$125,300$126,110$810)

18. BenchmarksCompensation (Base Salary and Incentive)Clinical Faculty/ProvidersAssociation of American Medical Colleges (AAMC) Midwest, by Rank154 accredited medical schoolsMedical Group Management Association (MGMA)12,500 organizations of all sizes, types, structures and specialties American Medical Group Association (AMGA)420 medical schools and practice groups, 220K providersResearch FacultyAAMC Midwest, by RankAAMC National, by Rank

19. BenchmarksProductivityClinical Productivity – wRVUs/ASAsFaculty Practice Solutions Center (FPSC)90 academic practice plansMGMAResearch Productivity – % of salary covered on grants/trialsInternal benchmark – workload documentsTarget25% unfunded MD (75% funded)50% unfunded PhD (50% funded)Aspirational Goal15% unfunded MD (85% funded)40% unfunded PhD (60% funded)

20. Salary BenchmarksSalary Benchmark Example

21. Clinical BenchmarksClinical Productivity Benchmark Example

22. Clinical Benchmarks

23. Research BenchmarksResearch Productivity Benchmark ExampleCalculate at individual level, but analyze data at department level($239,334)

24. Research Benchmarks

25. Research Benchmarks

26. Compensation PlansUCP has a central compensation planClinical faculty and providers onlyDepartments have addendums to document details of compensation methodologyUpdated annuallyPeriodically reviewed by UCP legalPrimary compensation modelsProfit/Loss (P&L)wRVUShift

27. Compensation PlansOverarching principlesConsistent with federal law, employment agreements require patient referrals to UCPC or UC Health facilities, with the exceptions:Patient preferencePatient insurance limits/requirementsIf not in the patient’s best medical interestReferral patterns will not be shared with any hospital or healthcare facilityCompensation will not be related in any way to referralsCompensation will be commercially reasonable and consistent with fair market valueCompensation will be set in advance and based on individual performance of services personally performedBase compensation may only be adjusted once annuallyIncentive compensation will be based on predetermined criteriaPaid regardless of the financial health of the department/division – it is an obligation if predetermined criteria are met

28. Compensation CommitteeMembersVoting: CoM Dean, UC Health CEO, UCP CEO, UC LegalNon-Voting: UCP Legal; UCP HR; CoM, UCP & UCH FinanceReviews annually all faculty/provider compensationIncludes all compensation, including affiliates (e.g., VA)Benchmark comparisonsCompensation < 20th percentile or > 80th percentile of benchmark requires explanation by departmentCompensation < 10th percentile or > 90th percentile requires external fair market valuationViewed along with effort and productivity, e.g., wRVUs, research funding, etc.Look for inequities and undesirable trends, which may lead to recommendations for action

29. Questions?