After ditching RVUs and shifting to a value-based compensation model, Morgantown, W.Va.-based WVU Medicine’s Heart and Vascular Institute grew from 25 providers to more than 200 in less than a decade while also expanding from a $225 million regional program to a $2 billion healthcare destination.
Vinay Badhwar, MD, executive chair of the WVU Heart & Vascular Institute and chairman of the department of cardiovascular and thoracic surgery at West Virginia University School of Medicine, joined Becker’s “Cardiology + Heart Surgery Podcast” to discuss the strategy behind the compensation model shift and how other health systems can learn from WVU Medicine’s success.
Editor’s note: This response was lightly edited for clarity and length.
Question: This move happened nearly a decade ago, moving the entire team off that RVU-based compensation. What did that shift entail and how did you make it work?
Dr. Vinay Badhwar: I know it sounds somewhat too good to be true, but the simplicity of the model works if you recruit thoughtful and quality-first physicians that are committed to the concept and energized to work hard — not for the RVUs but for doing the right thing for the right patient at the right time.
When you hire good docs and you remove as many of the nonclinical influences to practice as possible, the majority of the physicians flourish. We value productivity, of course, but we consider it a little bit more on the bonus side of things.
We pay salaries, at or above the appropriate market, based on level of skill, years in practice and how they’re going to contribute to the enterprise. The bonus structure, then, is not based on productivity alone. It’s a five-part element that provides some objectivity on teaching, academics and research, quality or service, citizenship and then productivity is the last piece. It’s not that we don’t value productivity, but all these other things are also important.
Listen to the whole conversation here.

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