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Aligning Physician Pay with Value-Based Care: Where Does the Buck Stop?

Aligning Physician Pay with Value-Based Care: Where Does the Buck Stop?
July 19, 2017 11:00 AM (GMT-04:00)
Healthcare News

There is no shortage of discussion about aligning physician compensation to reflect the dramatic industry shift from volume- to value-based medical care. Yet with such high stakes at risk, the question is how do you manage the change and who do you select to lead the transformation? 

While the buck ultimately stops with the Chief Executive Officer (CEO) or Chief Financial Officer (CFO), what we see among the many medical groups and health systems we work with, is a host of new leadership roles emerging to not only redesign compensation plans but to effect a cultural change overall.

Compensation Gurus

Charting the path to a new compensation model is particularly challenging for larger organizations that have been through multiple acquisitions and mergers. Some have 20 to 30 different compensation plans that must be organized and standardized to create a view of the current state, before they can even begin to design a future state compensation model. This requires a healthcare leader with knowledge of the current laws and regulations that govern physician contracting, practical experience with different types of incentive plans, and an understanding of how they tie-in with risk-based payer contracts.

Financial Leaders

The role of the CFO, in many medical groups, has been spread thin between practicing financial oversight, revenue cycle management and compensation plan maintenance. As a result, new positions have emerged that focus on financial tracking and monitoring of what are often new and culturally sensitive quality, efficiency and patient satisfaction metrics impacting physician compensation. Individuals in these roles must be financially savvy to ensure data accuracy, must possess an engaging presence, be able to coach physicians on ways to manage their incentive plans and take a fair and transparent approach to resolving compensation discrepancies or plan changes.

Patient Ambassadors

As physicians are increasingly asked to spend more time practicing at the top of their license, medical groups and health systems are investing in new roles to help ensure a positive patient experience and to reduce readmissions -- both of which are potential compensation levers for physicians. In addition to Physician Assistants and Nurse Practitioners, new roles on the clinical team include “Patient Navigators” who follow-up after discharge to monitor patient compliance regarding medications, lab work and doctors’ visits. There are also “Customer Experience” specialists who are focused on collecting patient feedback, analyzing results and making recommendations for systematic improvements in the patient experience. Finally, medical groups participating in shared risk are investing in “Utilization Managers” to monitor efficiency of care and use of best practices against contract quality benchmarks to improve overall financial performance.  

While physician compensation is a critical factor in realigning the organization, it takes a team of healthcare professionals, each with a unique skill set and perspective, to support the physicians’ and organization’s success in this new healthcare environment.

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