Are you utilizing a CARTS model. This, in theory, compensated providers for all the responsibilities. Those who chose to be more productive clinically, will do so by generating more RVUs.
We must first understand why physicians took call historically. Historically, call was a responsibility that physicians accepted to grow their practice and gain exposure to the community. Most physicians would have already been appropriately compensated for their work and as such accepted this burdensome responsibility. Over the years call has become something that increases the risk for being sued and it work does not equal appropriate compensation. There is no reward monetarily or regarding time. To expect physicians, to continue to take call without giving back will ultimately result in the hospital losing quality doctors and more importantly increasing doctor frustration and potentially a drop in productivity. My suggestion, is that you have to give to get. Rather than compensation, can you give the doctors the next day off or a reduced work load without financial penalty. I believe you need to also identify cost saving opportunities that could potentially offset the call pay. Challenge each department to find the savings that could be reallocated to call pay. Remember, not paying with either time or money is not an option. Its simply a recipe for disaster.
you’re model is an interesting one. Essentially you’ve moved to a salary model but are still compensated via Fee for service. You clearly need a blend where the providers have a base tied to production, with a potential for increase with increased production. They also need a quality incentive to mimimize over utilization. How you weight the compensation will incentivize the providers differently.