Unless you’ve been living under a rock, most of you have seen the explosive growth and wide-spread adoption of telehealth over the past year. It’s no longer the “wave of the future”; it’s the current reality.
One form of telehealth is called live-interactive videoconferencing and is most commonly used for remote call coverage. Remote call coverage is being heavily used by rural hospitals and medical centers to connect rural providers and their patients to specialists located at distant sites. This service enables the rural hospital to secure the much-needed coverage of a specialist who is otherwise difficult to recruit, and locum rates are exorbitant. In addition, patients can receive quality care in their communities and avoid long travel times.
Telehealth is not only being utilized by rural healthcare providers but also urban facilities. In 2020, CMS lifted restrictions that previously limited Medicare reimbursement coverage of telehealth services to rural beneficiaries presenting at a healthcare facility. Now, Medicare covers telehealth services without regard to geography or patient location.
At HVG, we’re seeing remote call coverage arrangements structured with two different components: 1) hourly rate to be on-call, and 2) hourly rate per consult and or episode. Depending on the specialty, a physician can be required to consult for a minimum amount of time as part of their on-call compensation. After a certain number of minutes or hours, the physician is compensated for his/her time.
So, the question becomes; “what is the FMV compensation for remote call coverage?”. Interestingly enough, according to SullivanCotter’s 2018 Physician On-Call and Telemedicine Compensation Survey Report, prior to the pandemic, only 52% of providers who furnished telephonic call coverage received compensation. 40% of physicians reported receiving an hourly rate for consulting time; 30% reported a flat rate per consult, and 20% of the physicians reported being paid 100% or a lower percentage of the specialty’s traditional unrestricted call rate.
Because a physician can take a call from almost anywhere, rather than being restricted to within 30 minutes of the hospital, the “burden” is lower. Remember, when we talk about call coverage, it’s all about the burden. So, currently, we’re seeing the FMV rate for remote call coverage is falling anywhere from 25% to 50% of the traditional on-call coverage rates published in the popular surveys. The additional/extra consulting time is a function of the specialist’s clinical compensation.
As always, each arrangement and specialty is different, and the specific facts and circumstances must all be taken into consideration. Historical call frequency, duration of a call, episode type, and specialty type are just some, but not all, of the factors that can have an impact on the % of unrestricted call rate the appraiser applies.
As telehealth continues to grow, I’m sure we’ll see more telehealth compensation survey data emerge.