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Consultants outline new physician compensation models, implementation plan and transparency tools
Summary
ECG management consultants presented a redesigned physician compensation program for Tahoe Forest physicians, proposing three models (salary/shift, productivity with call recognition, and productivity with daily call stipends), a target implementation date of July 1, and a compensation administration platform for transparency.
ECG management consultants presented a redesign of physician compensation to the Tahoe Forest Hospital District board and staff on Feb. 27, proposing three practice‑type compensation models, a staged implementation plan and administrative changes intended to increase transparency and trust.
Tony Cobalt and Tanner Heady of ECG described a future‑state plan with three primary models: a salary/shift‑based model for coverage specialties such as hospitalists and emergency medicine; a productivity‑based model with variable incentives for specialties that do not provide continuous emergency coverage; and a productivity model that separately recognizes intensive 24/7 on‑call specialties with daily stipends for on‑site call, intended for services such as orthopedics and obstetrics.
Tanner Heady said the redesign aims to “pay competitively to local market benchmarks,” account for Tahoe Forest’s higher local cost of living, and expand opportunities to reward quality, access and patient experience in addition to work RVUs. The consultants told the board a steering group of seven physicians had reviewed the proposed changes and that individualized “before and after” compensation snapshots for each physician would be distributed to reduce surprises.
Trevor Clifton of ECG described steps to build compensation administration capacity, including a plan to stand up a dedicated team, implement a compensation administration platform called Simplify and create a joint compensation committee with clinical and administrative membership to govern changes and adjudicate disputes. Clifton said the intent is to provide physicians with monthly visibility into productivity, accruals and incentive calculations.
Board members asked about trust and staging. Scott Baker, vice president of physician services, told directors the organization has increased transparency and is providing “shadow reports” that compare current and proposed pay so physicians can see expected results before the new model goes live. Director McGarry asked whether the district could run new and old calculations in parallel; consultants said that shadow reporting is planned and that some groups have already expressed interest in earlier adoption. Radiology, the presenters said, began a new compensation program in December and is already operating under the updated structure.
Consultants said target next steps include specialty‑level work to define quality measures (anticipated to take around a year in some service lines), deployment of the Simplify platform between summer and fall, standing up a compensation committee, and a proposed implementation target of July 1 for initial plan elements. They emphasized staged rollout and ongoing physician engagement.
