Also available in these eBook formats.
Max Reiboldt and Justin Chamblee
Sure, you're busy. But is your medical practice productive?
RVUs at Work: Relative Value Units in a Changing Reimbursement World, 3rd Ed. is a practical print (and eBook) by Coker Group's Max Reiboldt and Justin Chamblee that gives medical practices roadmap for the transition from fee-for-service to fee-for-value-based payment systems.
The reimbursement models are in transition causing confusion and uncertainty in the healthcare community. (MACRA and MIPS) By using RVUs in the correct manner, there is confidence that the provider gets paid for all the services he or she is rendering.
This book provides the latest information on RVUs and applies working knowledge to executives who are tasked with measuring various areas of productivity in the medical practice within the current healthcare landscape. Specific recommendations around physician productivity in the context of RVUs and the accountable care era are covered, including quality outcomes and allowable reimbursement.
Noteworthy Features for the 3rd Edition
- Expands the content well beyond just “RVUs” to consider other key considerations in the healthcare environment
- Takes into consideration hot topics in the current market, such as MACRA and MIPS
- Specific content is included that is focused on the current value-based environment
- Updates RVU-based content to current market practices. Given that the last version was published four years ago, that is like four decades in the healthcare realm
- Includes a specific chapter focused on technology, Securing the right technology to attain necessary data to provide to the right people at the right time.
- Includes a specific chapter on the care coordination process
- Specifically considers practice management in the current healthcare environment, balancing fee-for-service and fee-for-value.
- Practical -- includes examples of how different real-world medical practices are using RVUs to cut costs, enhance efficiency, boost profitability, and assure quality of care.
Although RVUs (Relative Value Units) were created as a payment methodology for Medicare, they have evolved into a valuable practice management tool used to track provider productivity, measure and define costs, negotiate managed care contracts, compensate physicians and benchmark key indicators. If you aren't tracking them and using them to their full value in medical practice management, you're missing a key piece of your practice's success
The transition from fee-for-service to fee-for-value-based payment system is extremely concerning to healthcare providers. This book unwraps the critical issues and presents solutions for handling these challenges. Read this book and you'll have a feeling of competency in this confusing reimbursement system.
This book is directed to the following: Physicians, Practice Administrators and Office Managers, Hospital Network Administrators, Consultants, Revenue Cycle Managers, Healthcare Attorneys.
Table of Contents
- Chapter 1: Recent History and Background of Units of Measurement
- Chapter 2: MACRA and Units of Measurement
- Chapter 3: Physician-Hospital Alignment in a Value-Based Environment
- Chapter 4: Compensation in a Value-Based Reimbursement World
- Chapter 5: Legal Considerations of the Value-Based Reimbursement Era
- Chapter 6: The Playbook for wRVU-Based Alignment Structures and Alignment Models
- Chapter 7: Value Units and Technology
- Chapter 8: Management in a Hybrid Reimbursement Environment Performance Measurement
- Chapter 9: Care Coordination Processes
- Chapter 10: Conclusion and Summary Concerning Value Units
Max Reiboldt, CPA is president/CEO of Coker Group with 44 years of total experience; the last 25 years specifically focused on healthcare. He has experienced first-hand the incredible changes of healthcare providers, which uniquely equips him to handle strategic, tactical, financial, and management issues that health systems and physicians face in today's evolving marketplace.
From his extensive work with health systems/hospitals, medical practices, and related healthcare entities, Mr. Reiboldt understands the nuances of the healthcare industry, especially in such a dynamic age. He understands healthcare organizations’ needs to maintain viability in a highly-competitive market. His experience of having “experienced everything” in the healthcare industry equips him to provide pertinent counsel to clients. Whether a transitional provider or a more cutting-edge healthcare entity, Mr. Reiboldt is uniquely qualified to work with these organizations to provide sound solutions to every day and long-range challenges.
As president/CEO, Mr. Reiboldt oversees Coker Group’s services and the general operations of the Firm. His “first love” is working with clients, providing sound financial, strategic, and tactical solutions to hospitals and health systems, medical practices, and other healthcare entities through keen analysis and problem-solving. Working with organizations of all sizes, Reiboldt engages in consulting projects nationwide.
An avid writer and speaker, Reiboldt enjoys educating healthcare leaders through books, white papers, articles, and speaking at national symposiums. His expertise encompasses physician/hospital alignment initiatives, hospital service line development, clinical integration initiatives, financial analyses (including physician compensation plans), mergers and acquisitions, hospital and practice strategic planning, ancillary services development, PHO/IPA/MSO/CIN development, appraisals, and “accountable care era” consultation. As the industry moves to adapting to many changes in response to healthcare reform, including the entire “volume-to-value” paradigm, he leads Coker Group’s efforts in this arena.
Justin Chamblee, MAcc, CPA is a senior vice president and director of operations at Coker Group. As an executive healthcare consultant and certified public accountant, he provides strategic and financial counsel to healthcare organizations, physician practices, and healthcare attorneys throughout the country, dealing primarily with physician compensation and hospital-physician transactions. His work in physician compensation involves strategy, by assisting healthcare organizations to restructure their compensation arrangements to ensure they are consistent with the market on a macro and micro basis. Chamblee’s work also involves compensation valuation, by helping healthcare organizations ensure that their financial arrangements comply with the requirements of fair market value and commercial reasonableness. Other areas of expertise include contract negotiations, sale/acquisition negotiations, strategic planning and business plan development, and other areas of finance.
As a recognized thought leader, Chamblee frequently presents at national conferences where physician leaders, healthcare legal counsel, and health system administrators gather to gain knowledge in the areas of physician compensation and hospital-physician integration. He has also authored several books and professional publications in collaboration with Greenbranch Publishing, Healthcare Financial Management Association, the American Medical Association, and HealthLeaders Media.
In addition to his consulting role, Mr. Chamblee is Coker’s director of operations, directing the day-to-day functioning of the company.
He has a BBA in Accounting and a Master’s in Accounting from Abilene Christian University, licensed as a Certified Public Accountant in the State of Texas, and a member of the American Institute of Certified Public Accountants. Additionally, he has completed extensive training through the Harvard Business School Leadership program.
"Now, more than ever, it has become increasingly important for private practice physicians and hospital-owned physician practices to better understand the productivity of their providers. The 1st Edition of RVUs at Work was extremely beneficial to me, personally, and to upper administrative management within our organization. The book explains the evolution of "where we were" to "where we need to be" in terms of benchmarking productivity. This is critical and useful in day-to-day operations and in the development of physician employment contracts covering 1) what is expected from a physician, and 2) how to incentivize highly productive physicians. Since there is no one-size-fits-all approach, the book includes many useful tools for different methodologies. I have recommended the 1st Edition of RVUs at Work and I highly recommend the newly revised 2nd Edition."
Carol Aiken,CMM,CPAR Physicians Network Compliance & Managed Care Contracting
"Coker's publication, RVUs at Work, has been utilized across our organization and has provided us with very relevant and helpful "blocking and tackling" view of the current culture of wRVUs and their application in today's medical practice."
Community Health Systems, Inc.