Making the Move from Volume to Value-Based Physician Compensation

Physician compensation models are evolving to keep up with the new quality metrics defined by the Medicare Access and CHIP Reauthorization Act (MACRA). Switching from a fee-for-service structure to a value-based payment model changes the focus to providing better quality using less resources. Before making the leap, health care organizations need to have a plan that considers how physicians will be impacted adjusting to the new quality metrics.

Benefits of Value-Based Compensation

Value-based models help increase the quality of care for patients while providing benefits for health care organizations and physicians.

  • Managed Care Contracting – MACRA’s Quality Payment Program (QPP) allows physicians to benchmark themselves across the industry and potentially earn higher bonuses for high performance.
  • ACO Participation – Participating as an Accountable Care Organization (ACO) provides better positioning and allows a practice to qualify for shared savings under the Medicare Shared Savings Program. ACOs also receive resources and support such as health IT, data analytics and quality reporting.
  • Healthier Patient Population – With a focus on quality of care and physician compensation based on patient outcomes, a value-based model provides lower costs and better outcomes for consumers. These models emphasize helping patients recover from illnesses and injuries more quickly and avoid chronic disease. As a result, patients face fewer doctor’s visits, tests and medical procedures, and spend less money on prescription medication.

Developing a Value-Based Incentive Program

While there is a lot of confusion around exactly how to structure a value-based incentive program, below are a few steps to begin and manage the process.

  • Form a Committee – Strategically selecting a committee of stakeholders, executives and physicians will keep the project contained while gathering different perspectives. The committee should research what’s going on in the marketplace and evaluate options for implementing policies in the organization. Having physicians on the committee is vital to gaining their support and trust in the new program.
  • Compare Options with Goals – After diving into marketplace data and evaluating against your current compensation models, the group will need to define goals. What will you measure? How will physicians and teams be incentivized? Use these answers to guide your new compensation plans.
  • Communicate – Keeping the organization informed when plans are finalized is key to gaining trust in the plans. Make sure physicians can easily understand the methodology, reporting of data and timing of payments.

The tips above just scratch the surface of implementing a value-based compensation model. The Anders Health Care Group helps physician groups and health care organizations optimize physician compensation models. Contact an Anders advisor to find out how we can benefit your organization.