Compensation models for OB/GYN physicians has becoming increasingly complicated through the years. This is largely due to the provision and billing of obstetrical care as a global service along with multiple providers from different entities performing a portion of the overall service.
Obstetrical care is comprised of antepartum care, delivery, and postpartum care. When a single physician or practice provides all the services, it is billed as a global OB package using a global OB code. However, given today’s use of laborists under professional services agreements (PSAs) as well as the continued growth in advanced practice providers, obstetrical care is often provided by more than one provider or practice. So, how do health systems compensate employed physicians, laborists groups, or community physicians appropriately for obstetrical services? The challenge is how to equitably allocate the services that are otherwise bundled within the global OB case rate.
When isolating the delivery portion of the global, there are a few methods for allocating the reimbursement. Some methods rely on a flat fee to pay the delivering physician. Others may split the collections received. Things can become more complicated when physicians share not only the delivery, but the overall care of the patient during the maternity period. . . .
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