June 8, 2022 · 2:04 AM

In your perfect world, would you favor your doctor’s revenue mirror:

  • variety of sufferers seen and procedures carried out, or
  • prime quality of care, mirrored in prepared accessibility, decreasing price with out compromising care, compliance with science-based pointers, and affected person satisfaction/expertise, or
  • mixture of the above

In different phrases, would you like your doctor incentivized by quantity or worth?

It doesn’t matter what you need anyway, peon.

A recent study looked at salary arrangements for doctors in system-affiliated physician organizations in four states. The principle conclusion:

The examine outcomes counsel that regardless of development in value-based cost preparations from payers, well being methods at the moment incentivize physicians to maximise quantity, thereby maximizing well being system revenues.

This in-depth multimodal cross-sectional evaluation of compensation and incentives amongst well being system–affiliated POs [physician organizations] for which there’s larger publicity to VBP [value-based payment] and APM [alternative payment model] preparations in contrast with impartial practices discovered that quantity was the commonest type of base compensation by a large margin, being included by greater than 80% and 90% of POs for PCPs [primary care physicians] and specialists, respectively, and representing greater than two-thirds of compensation when included. Equally, actions to extend quantity have been probably the most generally cited means for physicians to extend their compensation. Base compensation incentives for physicians weren’t dominated by inhabitants or value-oriented funds, with solely a 3rd of POs reporting inclusion of capitation with PCPs and averaging solely a few third of whole compensation when included. Efficiency-based monetary incentives for value-oriented objectives, similar to scientific high quality, price, affected person expertise, and entry, have been generally included in compensation however represented a small fraction of whole compensation for PCPs and specialists in well being methods, working on the margins to have an effect on doctor habits. Taken collectively, these findings counsel that regardless of development in APMs and VBP preparations, these value-based incentives weren’t generally translated into well being system doctor compensation, which was dominated by volume-oriented incentives.

The issue is that it’s lots simpler to measure quantity than worth. Simple wins.

Steve Parker, M.D.

Ref: Physician Compensation Arrangements and Financial Performance Incentives in US Health Systems in JAMA Community

PS: Keep away from the medical-industrial complicated as a lot as is safely attainable. Let me assist.

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