On-Call Coverage Arrangements

On-call coverage arrangements with physicians are essential in managing any emergency department or acute care hospital service line. The rise in the uninsured population in the United States over the years, the burden and expense of coverage, and the shortages in the physician supply have led hospitals to have critical needs in sourcing physician coverage. As physicians have been increasingly more unwilling to provide this service without being compensated, various forms of compensated on-call coverage arrangements have emerged. Types of coverage arrangements and compensation structures can include restricted coverage, unrestricted coverage, activation fees, per-diem stipends, hourly pay, and guaranteed reimbursement for services rendered when called in.

VMG Health has insight into the latest trends and the various on-call compensation structures based on our extensive experience in valuing these types of arrangements. As a result, we can rapidly assist in confirming if a physician on-call arrangement, or other entity, is fair market value.

Compliance

Documentation illustrating that physician on-call compensation was set at fair market value represents best practice for compliance purposes. Based on regulatory guidance, fees should be derived based on a sound methodology reflecting the terms of the arrangement and relevant value drivers. Two examples of value drivers that should be considered in deriving a proper payment for on-call services include: 1) understanding which party (if any) is being reimbursed for the services 2) how often is a physician in that specialty needed emergently. VMG has a keen understanding of these factors, and a myriad of other valuation drivers associated with physician on-call arrangements.

Relevant Publications & Presentations relating to On-Call Arrangements

Call Coverage Payments: Trends, Regulations, Statistics and Valuation Considerations
Call Coverage: Should independent contractors be compensated more than employed physicians?
Trends and FMV Considerations in Structuring On-Call Coverage Payments
Orthopedic Surgery Call Coverage Payments: Understanding and Applying Survey Data