REACH: Recognizing Excellence and Access to Care at UCSF Health
A Department of Medicine Clinical Recognition and Incentive Program
REACH is a DOM clinical recognition and incentive program designed to provide additional financial recognition to faculty with substantial clinical responsibilities at UCSF Health. The program was developed in response to declining faculty engagement, particularly among clinically active faculty, and the considerable pressure associated with increasing productivity, patient access, and changing practice expectations.
REACH is designed primarily to support the most clinically active physicians, particularly those providing substantial ambulatory and inpatient care. It provides an annual bonus through one of two alternative pathways, with eligible faculty receiving the higher payment for which they qualify.
Eligibility
REACH is available to DOM faculty who provide clinical care at UCSF Health sites and participate in the DOM Compensation Plan. Fellows, MSP physicians, recall faculty, volunteers, and faculty whose UCSF appointment is less than 50% are not eligible.
To be eligible for a REACH bonus for an academic year, a faculty member must provide clinical service for more than six months during that year.
How the REACH Bonus Is Determined
There are two alternative pathways for earning an annual REACH bonus. Faculty will receive the higher of the two bonuses calculated under each pathway.
Clinical Credit Pathway
Faculty earn credits based on outpatient and inpatient clinical activity at UCSF Health. Each weekly outpatient E&M session equals one credit, and inpatient clinical FTE generates credits at a rate of one credit for each 40% of inpatient cFTE.
Partial credits are assigned to outpatient sessions occurring fewer than 44 weeks per year and to inpatient cFTE below 40%. Partial credits are then combined across clinical activities, with a credit awarded for each whole-credit threshold reached.
3 credits: $4,000
4 credits: $6,000
5 credits: $8,000
6 or more credits: $10,000 (max)
Example: A faculty member with 2.5 weekly outpatient sessions and 30% inpatient cFTE would receive 2.5 outpatient credits plus 0.75 inpatient credit, for a total of 3.25 credits. Because the combined activity reaches the three-credit threshold, the faculty member would receive a $4,000 REACH bonus under the Clinical Credit Pathway.
Clinical FTE Pathway
Faculty may alternatively qualify based on their overall clinical FTE at UCSF Health:
50% to less than 75% total clinical FTE: $4,000
75% or greater total clinical FTE: $6,000
Clinical Activity Included in the Calculation
Outpatient clinical activity is based on the same number of sessions as the COLA target for each faculty member. Inpatient cFTE is based on assigned rotations, excluding rotations paid through a moonlighting payment. Detailed guidance regarding the clinical activities included in the calculation will be provided to divisions.
Changes in clinical effort during the year, including changes in the mix of outpatient and inpatient work, are reflected in the calculation.
Precepting and Procedure Sessions
The Clinical Credit Pathway is designed primarily to recognize the substantial asynchronous clinical work associated with outpatient E&M sessions that is generally not captured in scheduled clinical time. Precepting and procedure sessions typically do not generate the same volume of asynchronous work and therefore do not receive separate credits under this pathway.
However, the clinical FTE associated with precepting and procedure sessions is included in total clinical FTE under the Clinical FTE Pathway, ensuring these activities are recognized within the overall compensation framework.
Part-Time Faculty
REACH is based on clinical activity rather than a faculty member’s overall appointment percentage. The payment is not prorated based on overall FTE. Therefore, a part-time faculty member who provides the same level of clinical service as a full-time faculty member would qualify for the same REACH bonus. Faculty must, however, participate in the DOM Compensation Plan, which requires an overall appointment of at least 50%.
New and Separating Faculty
New faculty must start at UCSF by December 31 of the academic year to be eligible for that year’s REACH bonus. For example, a faculty member who begins employment on January 15 would not be eligible for a REACH payment for that academic year but could become eligible in the following academic year. This is consistent with the DOM COLA policy, which requires faculty to start employment by December 31 to receive a COLA on July 1. The REACH bonus is not prorated based on a faculty member’s start date.
Separating faculty will qualify if they provide clinical service for more than six months during their final year. The REACH bonus is not prorated based on the separation date.
Leaves
If a faculty member provides more than six months of clinical service, their clinical activity is based on the period in which they were working and is not prorated. The intent is to avoid disadvantaging faculty who take a leave of less than six months. A faculty member who works for more than six months will therefore receive the same REACH bonus as a faculty member with the same clinical duties who provides service for the full year. This applies to parental, medical, and all other types of leave.
Transfers Between Sites
A transfer between DOM divisions does not by itself affect REACH eligibility. The calculation is based on outpatient clinical activity, inpatient cFTE, and total cFTE at UCSF Health. Faculty whose primary DOM appointment is at ZSFG or the SFVAHCS may therefore still be eligible based on their clinical activity at UCSF Health.
Why REACH Applies to UCSF Health Clinical Activity
REACH is funded entirely with central DOM resources. While central DOM resources are periodically used to support academic programs across sites, including iRAPS and NIH+, central DOM funds are not used to support clinical care at ZSFG or the VA. Clinical compensation at those sites is supported through their respective health system partners, the San Francisco Department of Public Health and the VA national office. DOM leaders at those sites will continue to work closely with their health system partners to advocate for market-competitive compensation.
Payment Timing and Program Continuation
REACH is an annual incentive program. Payments will be made once annually, usually in October following the academic year, after clinical activity has been reviewed and eligibility has been confirmed.
The intent is for REACH to become an ongoing annual recognition and incentive program. As with other departmental financial commitments, continuation of the program will depend on the department’s financial position.
Relationship to Other Compensation and Clinical Improvement Efforts
REACH is an additional recognition and incentive program. It does not replace continued advocacy for competitive faculty salaries, appropriate staffing, improved clinical operations, reductions in administrative burden, or improvements in working conditions at UCSF Health. While the individual payments are not exceptionally large, the program is intended to provide tangible recognition of the extraordinary work clinicians do every day for patients, the health system, and the department.
Questions and Administration
For more information, refer to these FAQs. Faculty should first contact their division manager with questions about REACH eligibility, clinical activity data, or payment calculations. Division managers may escalate questions to Michael Chen, Associate Chair for Finance, as needed.