Provider Clinical Time and Administrative Time / Doc # PHMG.SYS.52.2 / V # 3
PHMG System-Wide Professional Services Policy / Page: 1 of 4

SCOPE: Employed Physicians and Advance Practice Clinicians (“APC”) of PeaceHealth (collectively “Providers”) who are exempt from overtime pay requirements.

PURPOSE: To establish expectations for clinical time and administrative time for exempt Providers according to medical specialtyand full-time employment equivalent (FTE).

POLICY: Each exempt Provider is expected to fulfill the clinical time and administrative time expectations corresponding to the Provider’s medical specialty and FTE to the PeaceHealth System-wide Provider Compensation Plan Manual, which may be changed by PeaceHealth from time to time. The clinical time expectations shall include requirements regarding patient care or clinical activities directly related to patient care. Expectations for clinical or administrative time will be prorated for positions that are less than full-time.

All exempt Providers shall adhere to this policy, unless:

  1. Approved in writing by both the PeaceHealth Medical Group (PHMG) System Compensation Administrator and PHMG Network Physician Vice President(VP) or designee,and;
  1. Detailed in theProvider’s Physician Employment Agreement, or the Provider’s Human Resources file.

REQUIREMENTS:

  1. Upon hire, an exempt Provider’s FTE shall be approved by the PHMG Network Physician VPand reflected in the Provider’s Employment Agreementor in the Provider’s Human Resources file.
  1. The PHMG Network PhysicianVP or designee is responsible for determining the initial exempt Provider’s standard work schedule, appointment block times, and call responsibilities using FTE as a baseline. The FTE,workweek, and standard work schedule must be documented in Lawson.

2.1.Changes to the Provider’sstandard work schedule must be approved by the Associate Medical Director (AMD) and documented in Lawson.

  1. Changes in FTE status must be approved by the PHMG Network VP, reflected in a Revised Tab C to the Provider’s Employment Agreement and in the Provider’s Human Resources file, and documented in Lawson.

3.1.FTE status can only be changed at the quarter and no more than once a year with exceptions made for life events or ADA. Notice of a change must be received at least 30 days prior to the pay period in which it will take effect.

DEFINITIONS: The descriptions below are to be pro-rated based on provider FTEstatus.

  1. Primary Care

1.1.A 1.0 FTE is required to have 34 faceto face bookable clinic hours per week, MGMA median productivity in wRVUswith the following adjusted panel size:

Specialty / Panel Size
Family Medicine / 1800
Pediatrics / 2200
Internal Medicine / 1800
Geriatrics / 1500

1.1.1.Definition: Panel size is defined as the number of patients who have that provider listed as Primary Care Provider (PCP) and have been seen in the last 18 months.

1.1.2.APC panel size is 70% of that of physicians.

1.1.3.It is expected that providers will reach these panel targets no later than two (2) years from date of hire.

1.2.If a physician is on hospital call at least weekly, but less than twice weekly (4-7x/calendar months), thenthey are required to have 32 clinic hours and a standard panel size.

1.2.1.If the physician does not meet the above call requirements but does take 2-3 days of call/month, the following applies:

1.2.1.1.32 contact hours for any physician who participates in a weekend and weekday call pool and who is above median on average for the previous 6 mo.

1.2.1.2.33 contact hours for any physician who participates in the weekend call pool and who is above median on average for the previous 6 mo.

1.2.1.3.34 contact hours for any physician below median on average for the previous 6 mo.or who doesn’t participate in the call pool at all.

1.3.If on call 8 or more times/mo (an average ofabout twice weekly) then they are required to have 30 contact hours and 88% of patient panel (1600 patients for adult primary care).

1.4.Panel size and hourly credit for Urgent Care or Walk-in Clinic shifts.

1.4.1.Definition: UC and WIC require a 40 hour work week, therefore 8 hours/wk equals 0.2 FTE and 10 hours equals .25 FTE.

1.4.2.Providers must work a minimum 0.2 FTE/mo. in the UC or WIC for credit to be applied to the panel size and wRVU targets.

1.5.Panel size and hourly credit for Hospitalist shifts.

1.5.1.Definition: Hospitalists work 173 shifts/yr = 2076hrs/yr = 173hrs/mo. Therefore 0.2 FTE = 35hr/mo or three (3), 12hr shifts.

1.5.2.Providers must work a minimum of 0.2 FTE hospitalist shifts/mo. for credit to be applied to the panel size and wRVU targets.

1.6.No contact hour credit will be given for hospital rounds not associated with call or SNF visits as clinics are encouraged to create an internal SNFist model with 1-2 providers doing all the nursing home rounds.

1.7.Network Physician VP approval is required to close a panel.

1.7.1.A recommendation is to close no sooner than at least 10% over the above targets.

  1. Specialty Care

2.1.A1.0 FTE is required to work nine (9), half-day shifts per weekand meet median MGMA productivity in wRVUs.

2.1.1.Definition: A clinic shift is a minimum of 4,face to face bookable clinichours.

2.1.2.Half a day of surgery or procedure time is equivalent to a half-day clinic shift.

2.1.3.A full day of inpatient coverage equates to two (2), half-day shifts.

2.1.4.For clinic-based specialists this equates to 36,face to face bookable clinic hours per week.

2.2.Providers who take hospital call at least four (4), times per month may decrease to eight (8), shifts per week.

2.3.For providers with an admin component hourly credit will be given in the clinic.

HELP: For questions about this Policy, or assistance with understanding your obligations under this policy, please contact the PHMG Policy Coordinator.

End of Policy

The last page of this policy document contains approval, review and revision information only.

CREATION (Original Version):

Author: / Tom Hutchinson, PHMG System Program Mgr – Medical Group Development
Responsible Party: / James Farley, PHMG Interim VP
Reviewed/Approved By:
HR / Sue Kent / Date: / 10/2009
PHMG Policy Work Group / Date: / 3/2/2010
MGLT / Date: / 11/20/2009
Final Approver: / Rick Kincade / Date: / 11/20/2009

PERIODIC REVIEW:

Reviewer: / Date:
Reviewer: / Date:
Reviewer: / Date:

REVISIONS:

Responsible Party: / Bob Swanson, PHMG System VP- Mission People and Culture
Revised By: / Tom Hutchinson, PHMG System Program Mgr – Medical Group Development
Reviewed/Approved By: / MGLT / Date: / 10/20/2010
Approved By: / James Farley, PHMG Interim VP / Date: / 10/20/2010
Reason/Summary of Changes: / The word “associated” added in first bullet point under #1 of Definitions to describe chart dictation and review.

REVISIONS:

Responsible Party: / Bob Swanson, PHMG System VP- Mission People and Culture
Revised By: / HR Policy Work Group: Bob Swanson, PHMG System VP- Mission People and Culture; Dr. Karen Sharpe, PHMG System MD Medical Director Primary Care; Dr. Eleen Kirman, PHMG System MD Medical Director of Specialty Care; Blake Hausmann, PHMG HR Consultant.
Approved By: / MGLT / Date: / 11/15/2013
Reason/Summary of Changes: / Title Change from: PHMG Provider Full Time Employment Equivalent Standard to Provider Clinical Time and Administrative Time. Update to format style and doc numbering per current PH Standards of Policy formatting. Detail regarding FTE: F2F and Panel Size added.

RETIRED:

Requested By:
Approved By: / Date:
Reason for Retirement: