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The Standard Q2 2016

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Industry Perspectives

Meeting the Demand for Critical Care Physicians

Brandon Boyd, Recruiting Principal, Delta Locum Tenens

Advances in medicine and a nationwide focus on health and wellness are factors contributing to our longevity. As our population lives longer, there is an increased demand for critical care medicine—and the specialized physicians who treat these patients.

From Hospitalist to Specialist

Just five years ago, it was the hospitalist or internist who was expected to perform procedures required in the critical care unit. However, changes to our healthcare system structure, including coverage and reimbursement to hospitals, have had a dramatic impact on critical care.

 For example, under the Affordable Care Act (ACA), more people are insured today than ever before, which means there are more patients. Further, ACA has evolved the hospital business model: physician and hospital reimbursements have moved from a services-based system to a results-based system, requiring hospitals to reevaluate who treats patients in order to effect the best possible outcome.

 In the wake of these changes, the hospital’s foundational and physical structure has also evolved. Today, hospitalists have greater autonomy to assign patients to the specialist who is most qualified to achieve positive results. In addition, hospitals are reducing the number of inpatient beds in favor of sending any patient who might require specialty support to the critical care unit or the intensive care unit, resulting in a steady increase in the number of critical care beds. In fact, from 2000 to 2010, the number of critical care beds increased by 17.8 percent, according the Society of Critical Care Medicine.

 In addition, acute care hospitals and rehabilitation hospitals have become more prevalent—a clear demonstration of the increase in the number of specialized hospitals and units that treat the chronically ill who rely on critical care.

Filling the Critical Care Gap

These facts all point the reality that there will continue to be unprecedented demand for critical care physicians, and you can expect this need to continue on a strong and steady trajectory. Why? Because advances in medicine will continue to advance lifespans, and hospitals will continue to look for ways to improve outcomes. Their point of differentiation and competitive edge will be influenced by critical care medicine.

 Delta Locum Tenens offers award-winning staffing solutions for critical care medicine, and has been recognized as a top agency in the physician staffing industry for the past seven years. Visit Delta Locum Tenens for more about locum tenens staffing services.

Placements & Interviews

Placement Data by Specialty

This data represents average statistics of placements and interviews by Delta Physician Placement over the twelve-month survey period. Since these averages only include placements and interviews, the compensation information presented indicates the rate at which candidates are choosing to interview or sign. Average days information can be used to forecast a probable timeline for a recruitment effort in a particular specialty.

  Average Compensation Average Days
  Starting Compensation Sign-on Bonus Potential Compensation From Interview to Placement Total Placement Fastest Days-to-Fill
Primary Care
Family Medicine $223,310 $29,107 $253,103 34 122 17
Internal Medicine $222,000 $21,786 $235,500 30 108 32
Obstetrics/Gynecology $336,250 $33,750 $400,000 15 97 51
Pediatrics $213,857 $18,571 $266,429 16 144 36
Psychiatry $243,263 $25,667 $276,111 17 174 22
Family Medicine- Obstetrics $277,500 $37,500 $152,500 109 98 13
Urgent Care $280,000 $30,000 $280,000 6 131 131
Surgery
Orthopedic Surgery $583,333 $45,000 $766,667 31 206 58
Otolaryngology $475,000 $37,500 $475,000 20 63 49
General Surgery $384,799 $35,714 $419,286 38 66 54
Urology $490,000 $39,000 $600,000 47 174 51
Sub-Specialty
Gastroenterology $566,667 $35,000 $616,667 49 130 72
Neurology $300,000 $30,000 $350,000 12 183 105
Hospital-Based
Emergency Medicine  $302,545 $13,333 $319,795 27 147 94


Data reflects averages from placements and interviews by Delta Physician Placement from July 2015 through June 2016. “Potential Compensation” data reflects average yearly compensation at full production excluding benefits. “Average Days” data does not include off-contract placements. “Average Days Total Placement” data is calculated from profile to placement. 


Placements by Population

Placements by Population

Data indicates sources of candidates for placements and interviews from July 2015 through June 2016.

Candidate Sources

Candidate Sources

Data indicates sources of candidates for placements and interviews from July 2015 through June 2016.

Market Demand

Nationwide Search Distribution

Nationwide Search Distribution

Map represents searches initiated by Delta Physician Placement on behalf of healthcare facilities from July 2015 through June 2016.



Specialty Demand Comparison

  2nd Quarter 2016 2nd Quarter 2015
1. Family Medicine Family Medicine
2. Family Medicine - Obstetrics Psychiatry
3. Psychiatry Gastroenterology
4. Internal Medicine Obstetrics/Gynecology
5. Neurology General Surgery
6. General Surgery Urology
7. Obstetrics/Gynecology Emergency Medicine
8. Pediatrics Hospitalist
9. Gastroenterology Orthopedic Surgery 
10. Otolaryngology Otolaryngology
11. Pulmonary Critical Care Medicine Pediatrics
12. Urgent Care Cardiology- Non-Invasive
13.

Allergy

Family Medicine - Obstetrics
14. Anesthesiology Internal Medicine
15. Cardiology-Electrophysiology

Psychiatry- Child & Adolescent


Data compares the top 15 most requested searches initiated by Delta Physician Placement, comparing the second quarters of 2015 and 2016.

Search Distribution Specialty

Search Distribution Specialty

Data indicates the percentage of searches initiated by specialty grouping between July 2015 through June 2016.



Candidate Placements

  Top 5 States Providers Have
Taken New Opportunities
1. Texas
2. California
3. Iowa
4. Minnesota
5. Ohio


Compares all states for the top 5 candidate placements as initiated by Delta Physician Placement from July 2015 through June 2016.

Locum Tenens

Days Requested - Top Specialties

Days Requested

Data indicates the top specialties by days requested from July 2015 through June 2016.

Nationwide Physician Distribution

Nationwide

Map represents searches initiated by Delta Physician Placement on behalf of healthcare facilities from July 2015 through June 2016.

2nd Quarter 2016 
July 2015 - June 2016

Industry Perspectives

5 Things to Know about MACRA Physicians

It’s here: Centers for Medicare & Medicaid Services (CMS) has released its new proposed rules for the Medicare Access and CHIP Reauthorization Act, known simply as MACRA. The changes by CMS are intended to leverage the performance-based payment system (also known as value-based, results-based, outcomes-based, or merit-based), and will impact physicians and providers who participate in Medicare. What do you need to know to streamline the changes for your facility? While there is a wide variety of information available—and we’ve provided several helpful links below—every transformation begins with the basics. As such, here are five overarching things you need to know about MACRA.

Under the new rule, how will physicians and providers receive Medicare reimbursement?

There will be a two-track system: one track is for merit based incentive programs (MIPS) that participate in fee-for service, and the second track is for providers who are reimbursed through alternative payment models (APM). (More here.)

How can providers participate in the APM option?

CMS outlines the payment models that would qualify under the APM option as the Medicare Share Savings Program (MSSP) Tracks 2 and 3 (note: Track 1 does not qualify), Next Generation ACO Model, and Pioneer ACO programs.

When will payment changes and adjustments take place?

The new rule is slated to take affect January 2017. As such, performance in 2016 will not be impacted. The activity in 2017 will impact payments in 2019. (More here.)

How will Meaningful Use (MU) initiative be impacted?

MU is an incentive-based program for using electronic health records (EHR). One of the biggest changes is that MU would no longer be its own independent program. Under MARCA, EHR would account for 25 percent of the performance composite score, which is used to determine Medicare payment. (More here.)

Will MACRA impact reporting?

Yes. Providers will be forced to report the quality of care via the physician quality report system (PQRS), and the results will impact reimbursement. (More here.) The American Medical Association (AMA) offers valuable downloadable information on PQRS reporting under both MIPS and AMS.

The Best Advice: Be Prepared

While the proposed MARCA changes are detailed and robust, being prepared is key to success. The professionals at The Delta Companies are here to help with insight and information. In addition, there is a wealth of information on the AMA site, including a checklist to prepare for the upcoming changes.

Placements & Interviews

Placement Data by Specialty

This data represents average statistics of placements and interviews by Delta Healthcare Providers over the twelve-month survey period. Since these averages only include placements and interviews, the compensation information presented indicates the rate at which candidates are choosing to interview or sign. Average days information can be used to forecast a probable timeline for a recruitment effort in a particular specialty.

  Average Compensation Average Days
  Starting Compensation Sign-on Bonus Student Loan Repayment Relocation Reimbursement From Interview to Placement Total Placements Fastest Days-to-Fill
Rehabilitation
Occupational Therapist $82,702 $9,236 $23,455 $4,450 7 65 15
Physical Therapist $82,223 $12,480 $11,038 $4,151 9 68 1
Physical Therapy Assistant $60,125 $12,875 - $4,200 4 19 11
Extenders
Nurse Practitioner $109,068 $10,161 $35,857 $6,034 14 96 11
Physician Assistant $101,250 $10,00 - $3,750 14 72 19
Allied/Other
Dentist $136,667 $8,125 $41,667 $5,714 17 76 17
Licensed Clinical Social Worker $52,667 $2,880  $20,000  $3,800 7 50 16
Nursing
Case Manager $89,440 $8,000 -  $12,500 3 37 37
CRNA $150,000 - - - 23 44 44
Director of Emergency Dept $105,000 $3,000 - $4,000 7 76 76
Nurse Manager of Medical/Surgical $92,000 $5,000 - $3,500 3 64 64
Nurse Manager of Surgical Services $95,000 $5,000 - $5,000 3 17 17
Registered Nurse $73,015 $6,861 $31,894 $9,042 7 59 7


Data reflects averages from placements and interviews by Delta Healthcare Providers from July 2015 through June 2016. “Average Compensation” data reflects average yearly compensation for each position listed above. “Average Days” data does not include off-contract placements.


Placements by Population

Placements by Population


Data indicates the percentage of placements made from July 2015 through June 2016 by the population of the search facility's metropolitan area.

Years of Experience

Years of Experience

Data indicates the average years of experience of candidates for placements and interviews from July 2015 through June 2016.

Market Demand

Nationwide Search Distribution

Nationwide Search Distribution

Map represents searches initiated by Delta Healthcare Providers on behalf of healthcare facilities from July 2015 through June 2016.



Candidate Placements

  Top 5 States Providers Have
Taken New Opportunities
1. Texas
2. California
3. Arizona
4. New Mexico
5. Arkansas


Data is compiled from assignments placed by Delta Healthcare Providers from July 2015 through June 2016.

Specialty Demand Comparison

  2nd Quarter 2016 2nd Quarter 2015
1. Physical Therapist  Registered Nurse
2. Nurse Practitioner

Physical Therapist

3. Registered Nurse Nurse Practitioner
4. Medical Technologist Occupational Therapist
5. Occupational Therapist Dentist

 


Candidate Sources

Candidate Sources


Data indicates sources of candidates for placements and interviews from July 2015 through June 2016.

Staffing

Facility Demographics

Facility Demographics Charts


Data is compiled from assignments placed by Delta Healthcare Providers from April 2015 through June 2016.



Years of Experience

Years of Experience


Data is compiled from assignments placed by Delta Healthcare Providers from April 2016 through June 2016.