What I Did on My Summer Vacation

One of the best parts of my “job” as a more-or-less emeritus member of SHM’s Practice Analysis Committee is the chance to be involved up close and personal in the development, analysis, and reporting of the biannual State of Hospital Medicine (SoHM) survey. In fact, I’ve either led or been integrally involved in every SoHM survey since 2006, and that has enabled me to gain an extremely valuable perspective on how the specialty of hospital medicine has evolved over the last 10 years.

During the last few weeks, I’ve been up to my eyeballs reviewing sections of the new 2016 survey report that were drafted – as was the case in 2014 – by Patrick Vulgamore, MPH, SHM staffer extraordinaire. While some of the data is still being analyzed, my excitement is growing about the new survey results. The State of Hospital Medicine Report will be available to the public once the report gets pushed through a gauntlet of committee review, copyediting, graphic designers, web designers, and printers.  The target release date is late September; in the meantime, allow me to whet your appetite.

This year, we had our best survey response ever, with a total of 595 hospital medicine groups (HMGs) participating.  One really interesting twist you will see reflected in the survey results is that we received much higher participation this year from hospitalist management companies than has been the case in the past – in fact, 41.5% of the respondent groups were owned/employed by a management company. Sadly, despite the higher overall participation numbers, the number of responses from pediatric HMGs this year dropped by about half from the 2014 survey. So we need a clear plan (and ideally a pediatric hospitalist champion) for increasing pediatric hospitalist participation in 2018. We also had about a 20% drop in the number of self-defined academic HMGs reporting.

This year we had the opportunity to ask several new, never-before-asked questions, including:

  • The percentage of the hospital’s total patient volume (for the population the group serves, i.e., adult vs. children vs. both) the HMG was responsible for caring for
  • The presence of medical hospitalists within the HMG focusing their practice in a specific medical subspecialty such as critical care, neurology or oncology
  • The value of CME allowances for hospitalists
  • The utilization of prolonged service codes by hospitalists
  • Charge capture methodologies being used by HMGs
  • For academic HMGs, the dollar amount of financial support provided for non-clinical work

In addition to these new questions, the SoHM will also have the usual information about things like scope of clinical practice, HMG staffing, skill mix, schedules, leadership structure, compensation and benefits, CPT code distribution, and practice finances. And SHM has again licensed MGMA’s just-released 2015 productivity and compensation data for hospitalists for inclusion in the report. As has been the case for the last several years, hospitalist compensation continues to rise at a faster pace than hospitalist productivity, with median compensation for internal medicine hospitalists increasing by 9.6% over the two-year period while wRVUs remained essentially static. Another interesting tidbit I have permission to share: the amount of financial support being provided to HMGs per physician FTE rose by only about 1%, from $156,063 to $157,535. I wonder, then, how are HMGs funding those higher hospitalist salaries?

Those of you who participated in the survey will again receive free access to the new, extra-cool revamped digital version of the SoHM report with much-improved search capabilities. Otherwise, keep your eyes open for the announcement this fall that the report is available for purchase. If you’re like me, you can’t wait to see what else has changed over the last two years!

Leslie Flores

Leslie Flores is a founding partner at Nelson Flores Hospital Medicine Consultants, a consulting practice that has specialized in helping clients enhance the effectiveness and value of hospital medicine programs as well as those in other hospital-focused practice specialties since 2004. Ms. Flores began her career as a hospital executive, after receiving a BS degree in biological sciences at the University of California at Irvine and a Master’s in healthcare administration from the University of Minnesota. In addition to her leadership experience in hospital operations, business development, managed care and physician relations, she has provided consulting, training and leadership coaching services for hospitals, physician groups, and other healthcare organizations. Ms. Flores is an active speaker and writer on hospitalist practice management topics and serves on SHM’s Practice Analysis and Annual Meeting Committees. She serves as an informal advisor to SHM on practice management-related issues and helps to coordinate SHM’s bi-annual State of Hospital Medicine Survey.

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