Q With production-based pay, who gets credit for the "sale" of a plan and who gets credit for services rendered?

Because annual wellness plans are purchased at one time, but services are rendered throughout the year, the answer to production-based pay for these plans is up to each individual hospital, says Mark Opperman, CVPM, owner of VMC Inc., a veterinary consulting firm based in Evergreen, Colo.

"When some practices start offering wellness plans, they invoice the client at the time of service and then transfer the charge to a new file for the 'wellness client,'" Opperman says. "They can keep track of these services and determine if it's cost effective to continue offering the plans."

"This works fine if all doctors perform outpatient procedures about equally," he says. "But if one of your doctors primarily does surgery you will have to adjust for that."

Given the two options—tracking specific services rendered and crediting the doctor at the discounted amount or breaking out a wellness plan among your various doctors based on the hours they work per week—Opperman prefers the former. It may sound more complicated to charge the client for the services at the time they are rendered, you will either have to apply a discount or come up with new service codes for services offered under the wellness plan, but I think it is a better way to go." Not only will doctors receive credit when they provide the service, albeit discounted, but management will be better able to track the effectiveness of the program: Does it provide better client compliance, better long-term revenue, and result in better patient care?