Transplant Surgery: Part-Time Travel Coverage Agreement

A hospital (“Hospital A”) affiliated with a large for-profit health system was seeking compensation guidance for providing part-time services of a highly specialized transplant surgery physician group (“Group”) to an out-of-market hospital (“Hospital B”).

Situation

Hospital B was seeking to secure various specialty transplant surgery services to meet the community demand, patient volume, and transplant designation requirements of the market. Hospital B had historically experienced difficulty recruiting and maintaining specialized transplant surgeons required to fulfill the Organ Procurement and Transplantation Network (“OPTN”) guidelines. The guidelines must be strictly followed by each OPTN certified facility to operate a transplantation program. Hospital B requested to contract with the Group to travel to the hospital and provide clinical, administrative, and teaching services to meet the aforementioned guidelines on a temporary basis until permanent coverage could be secured.

Solution

In order to determine an FMV payment for the Group's services, VMG Health considered transplant surgery clinical compensation market survey data, the physicians’ unique education, experience, and certifications, and the expenses associated with the part-time nature of the services. In addition, VMG Health considered the community need and the possible impact on quality of care in the market, should the services not be provided by the Group. As part of the analysis, VMG Health analyzed the expected duties and time required to fulfill these responsibilities, such as reviewing active patient cases, transplant acceptance committee meetings, the burden of on-call coverage services, and timely response to transplant patients. Ultimately, VMG Health conducted a cost build-up analysis to provide a daily FMV indication that encompassed all facets of the services provided by the Group to Hospital B.

Success

VMG Health determined the FMV compensation for each of the physicians’ provision of the clinical, administrative, and teaching services to the out-of-market hospital while considering the unique details and circumstances of the arrangement. The hospitals utilized the deliverable to aid in structuring a professional services arrangement to secure quality transplant surgery services at Hospital B.