Physician Compensation System

Automating Flexible Rules Based System Using Key Variables

  •  Healthcare
  •  Symfony & KendoUI

A leading healthcare technology solution provider aims to meet the real needs of providers. Physician compensation and payment reforms are the focus areas. There is a need to automate the existing flexible rules based system to rid the pain areas existing in healthcare.

Client Pain Area

The client was using an indigenously developed flexible rule based system that helped calculate the compensation using the fee-for-service model.

This system was manual, and required the administrator to enter the key variables that were needed to perform the calculation. The physician compensation calculation is dependent on variables such as skills of caregiver, training level, intensity of care, patients handled by caregiver, time taken by the provider, efforts extended towards the care etc. It is also dependent on the doctors, their specialty areas as well as their position.

Entering the data manually led to erroneous output, which used to cause disparity in the compensation.

The manual system was difficult to administer and monitor, and is not flexible either

It did not consider incentives as part of the compensation, which are decided based on behavior and quality.

It did not allow the health care administrators or physicians to adopt a compensation model of their choice, which restricted their compensation calculation methods.

Business Objectives

Client wanted to automate the existing flexible rules based system using managed care models such that it could analyze, adjudicate and manage the incentive based physician compensation using specific models and the necessary key variables.

The client was looking at a backend system that could integrate the different variables which could track and manage the incentives utilizing the data insights. The system would then use the specific data model to calculate the compensation, using the requisite variables.

They wanted a system that could ensure real time visibility of the data in order to avoid errors in calculation. The main aim of having this system was to make the incentive based compensation easy to administer and monitor thus reducing the existing disparity and improve overall productivity and performance of healthcare management.

The Solution

We proposed a physician compensation system using Symfony framework with KendoUI for backend interface and management. The proposed solution involved integration of client database to the existing manual system to automate the calculations.

Certain logic was built so that the calculation would take into consideration the compensation model and utilize the variables that are required. To consolidate and centralize this logic, stored procedures were used, which would access the relational database. The procedure would be user defined, which would fetch the required variables from the client database, thus expediting the calculations. The output was displayed in Kendo Grid.

Managing and monitoring the backend became easy. The administrators could easily add or delete information to the system. Functionality like filtering, searching, and sorting of data allowed easy to administer backend.

The solution involved role based security as well as user defined compensation measures.

The solution was both flexible and scalable, which made it future proof.

Development Environment

Technology & FrameworkSymfony Framework
LanguagesPHP 5.3.2
DatabaseMySQL 5.5.24
Web Server/Hosting PlatformApache
Operating SystemWindows

Deployment Environment

Technology & FrameworkSymfony Framework
LanguagesPHP 5.3.2
DatabaseMySQL 5.5.24
Web Server/Hosting PlatformApache
Operating SystemLinux

During the development, the team did not have access to the database for performing Store and Retrieve functionality due to security concerns of the client. The team had to connect with the existing database over OpenVPN and Remote MySQL to overcome the client concerns. This approach was challenging as the development environment had to be operational with a high bandwidth internet connection.

  • The new system with a robust backend could easily integrate complex physician compensation plans
  • It offered real time visibility to compensation metrics, KPIs as well as calculated results for physician compensation
  • Productivity and performance within the system increased considerably
  • This new system considers the skills and productivity of the physician before offering them compensation, which improved motivation levels
  • It helped retain the providers as they were compensated for the extra effort they put in along with their performance and productivity
  • Quality performance measures led to financial incentives