Despite efforts by insurance companies and other payers to move toward compensating physicians based on the quality and value of care they provide, most physicians employed in group practices owned by health systems are paid primarily based on the volume of care they provide, according to a new study by RAND Corporation researchers.
Examining a wide range of medical practices owned by health systems, researchers found that volume-based compensation was the most-common type of base pay for more than 80% of primary care physicians and for more than 90% of physician specialists.
While financial incentives for quality and cost performance were commonly used by health systems, the percentage of total physician compensation based on quality and cost was modest -- 9% for primary care providers and 5% for specialists.
Ad Statistics
Times Displayed: 7647
Times Visited: 24 Brand-New FDA-cleared Advanced Ultrasound Medical Device available for sale or lease to Wound Care Centers or any other Medical Facilities.The Arobella 1000D is designed for non-contact or debridement ultrasound wound healing therapy, or any other wounds
The findings are published by the journal JAMA Health Forum.
“Despite growth in value-based programs and the need to improve value in health care, physician compensation arrangements in health systems do not currently emphasize value,” said Rachel O. Reid, the study’s lead author and a physician policy researcher at RAND, a nonprofit research organization. “The payment systems that are most-often in place are designed to maximize health system revenue by incentivizing providers within the system to deliver more services.”
In recent years, both private and public payers have adopted payment reforms that seek to encourage health care providers to improve the quality of care delivered and slow spending growth in an effort to generate better value for patients. At the same time, the size of health systems and their employment of physicians has increased markedly.
To examine whether the compensation structure for physicians resembled the payment reforms focused on value, the study examined the physician payment structures used in 31 physician organizations affiliated with 22 health systems located in four states.
Researchers interviewed physician organization leaders, reviewed compensation documents, and surveyed the physician practice to characterize the compensation arrangements of primary care and specialist physicians.
Increasing the volume of services delivered was the most commonly reported action that physicians can take to increase their compensation, with 70% of the practices following such a plan. In these cases, volume-based incentives accounted for more than two-thirds of compensation.
