1. Adapting to the New Funds Flow
Tony Ngo
Tom McElderry
September 7, 2016

2. Goals for this talk Explain the new clinical funds flow
Explain Radiology’s hybrid model used to budget for funds flow payments
Discuss what has been done to mitigate the impact on the Department
Tony

3. What is “funds flow?”
Funds flow is the transfer of money between the Medical Center and the School of Medicine / clinical departments related to professional services
UCSF moved to a wRVU-based Funds Flow in July, 2014
But before we go on, let’s talk about who we are.

4. How did we get paid in the past?
Care
Faculty provide care to patients
Billing
Billing group bills insurance companies, other payers
Collections
Pro fee collections are passed back to departments
Deductions for billing costs, dean’s tax, direct expenses

5. Why did UCSFHealth adopt a new funds flow?
Increasing competition threatens UCSF market share
No financial incentive for departments to expand primary care
Primary care brings in new patients, feeds specialists
UCSF must expand to remain a top hospital and research institution

6. What is the new model
Redistribute Collections
Departments based on survey of private practice salaries
More work = more payments, providing incentive to expand services
Reduce Practice Expenses
Managed by UCSFHealth, which has incentive to streamline and reduce costs
Improve Care
Ensuring reasonable return for physician services increases availability of appointments
Expanded primary care increases volume for specialties

7. What are wRVUs? RVUs = Relative Value Units
Definition: a standard measure of resources required to provide physician services
wRVUs are the RVUs related to the physician’s work
Examples
Full body PET: 2.0 wRVUs
Chest x-ray with fluoroscopy: 0.38 wRVUs
Tony

8. The Hybrid Model – We choose by clinical section:
wRVU model OR
Staffing Model
MGMA $ per wRVU by subspecialty x actual wRVUs
MGMA compensation by subspecialty x clinical FTE (cFTE)
11/16/2018

9. Why is Qgenda important?
Qgenda is a calendar system used to track and report physician schedules
For staff model budget:
Shifts scheduled are converted to clinical FTE
Clinical FTE x MGMA median salary = staff model payment
We only are paid if shift if recorded in Qgenda

10. What is the impact on Radiology?
Significant reduction in overall payment
Coverage for so many sites means most sections are in staff model
Additional payment for adding a new faculty member in a staffing model section may not be sufficient to cover costs

11. What have we done to reduce the impact on Radiology missions?
Negotiated hybrid model
Negotiated additional joint venture for China Basin MRs
Supplemented bonuses to FY14 $/wRVU
Negotiated change in staffing model calculation
Support from Dean’s Office for CB Rent
Increasing efficiency in use of research space
Ongoing discussions with Dean’s Office, Transition Oversight Committee to mitigate impact of funds flow

12. How can you help? Offer ideas for cost savings
Help maintain accurate and consistent scheduling records in Qgenda
Encourage faculty to ensure accuracy in Qgenda schedule
Continue providing excellent service!

13. Thank you! Questions?