How Are Doctors Paid? Learn the Incentives in Physician Compensation
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- Опубликовано: 4 фев 2022
- RAND and Harvard University Researchers Recently Published a Study in the Journal of the American Medical Association Examining How Doctors are Paid by Hospital System-Owned Practices.
The Study Found that only 9% of Primary Care Physician Compensation was Based on Value (Quality and Cost-Effectiveness) and only 5.3% of Specialist Compensation was Based on Value.
The Study Concluded:
"The results of this cross-sectional study suggest that PCPs and specialists despite receiving value-based reimbursement incentives from payers, the compensation of health system PCPs and specialists was dominated by volume-based incentives designed to maximize health systems revenue."
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Find an independent doc near you and hold on to them tight.
I do!
#True
Wow so true a lot of hospitals do a revolving door which leads lots of patients being under-treated for care.
Thank you for watching and for your comment!
Thanks... Keep doing these great educational videos - You are a fearless disruptor that must be ethically grounded to do this great work and risk taking flack from other doc leaders.. I agree that patients and families must come first to have an ethical and long term, sustainable US healthcare system based on free market principles. I think the old guard in medicine are underestimating the standards of young docs coming into the system who will eventually know it is corrupted by money but that money is not satisfying personally after basic needs are met. Docs need inspiration, a societal mission, and an outlet for their passion and creativity, not just a sweet gig generating more money as a specialist? Primary care is a noble MD career and is where patients and families primarily go for help and protection from sickness. It is sad that we now know that next generation MDs don't follow their MD parents into primary care but pick "ROADS'for the money and higher status. THANKS
Thank you for your thoughtful comment. Appreciate you watching.
@@ahealthcarez hi you making some really good learning content, can you please create a video on clinical registries and it's overall impact
Thank you!
Its like fighting an uphill battle
#True. Thank you for watching and for your comment.
Thanks for posting new studies on the financial side of medicine.
Thank you for watching and for your comment!!
Another great video Eric - one of your better ones if there is such a thing because you clearly define the problem - and define the solution is to be independent
Thank you for watching and for your encouragement.
I really love the videos you put out. Please keep them coming. Would love to learn more about value based care, the different models. What MSOs do etc
Super! Thank you for watching!!
We need to go back to more independent practices and physicians having autonomy. Value-Based payments and purchasing in general have major flaws and the insurance carriers have continued to benefit from VBP programs. Hospitals and Physicians continue to work hard on improving outcomes, but the cost of practice overhead has only increased. A major piece of this expense is staff and physician recruitment.
Thank you for watching and sharing your perspective.
I have been thinking this for long. Volume should not be the only determinate of provider's comp. Do not quote me on this, but Kaiser may be a good example for how to not relay on RVUs, according to one of its providers. Need to research this more.
Thank you for watching and for your comment, Sam.
Amazing Video. Do you have a video around risk adjustment? And how it works?
No. Great suggestion.
A major hospital in my area charges more for every test. The hospital is in financial trouble. I think they are doing more and charging more for profits, even though they are non profits. The specialists work at that hospital.
Thank you for sharing your experience.
As far as I know, all profee charges are still FFS. So if a provider is contracted to a hospital, even if they are independent, it doesn’t seem like it will have an effect on reimbursement for profee.
Thank you for your point of view. Appreciate you watching.
Would you do a video on travel nursing? I'm a travel nurse and we're all over the news for what Congress is trying to do in cap our pay (indirectly, of course... going after our agencies for "price gouging"... but let's get real, the healthcare execs and their lobbyists are really targeting our high wages)
Good suggestion. Thank you.
What would be the effect of a reimbursement based on prepaid capitation (much like DPC practices) on quality outcomes?
Great question. Both ChenMed and Intermountain have seen increased primary care quality outcomes with capitation.
Thank you
You’re Welcome!
in your final point - you're suggesting that the juggernaut that is the large health care system imposes RVU based payment models on its providers? whereas independent physician practices are more free to innovate and experiment with new payment systems? am i understanding that correctly?
More like priority of hospital-run primary care is to feed referrals to specialists. Priority of independent primary care can be the patient.
Impressive insights.
Thank you for watching and for your comment.
I want to startup a medicare advantage plan in Alaska since it does not exist in that area what would you advise me as the first step?
Contact Sachin Jain from SCAN Health Plan in California. He knows much more than I do.
Why is it hard to convince hospitals to adopt VBC? Is it the mindset or the administration effort? Financially VBC should make sense for them, benefit more than fee based? Why they don’t see it that way if that’s the case. Thank you. If you answered already in previous videos, apologize.
VBC entails taking on risk… hospitals generally do not want to do that.
Fee-for-service does Not involve taking on risk and is what they are used to.
@@ahealthcarez thank you you the best
Enjoy your videos. The reason physicians in hospital practices are compensated based on RVUs is that it is the most compliant way to justify compensation. You must justify fair market value for compensation. Most use MGMA compensation survey to evaluate compensation including base and incentive compensation for a specific geography to establish fmv. The value based model for payment with RVU compensation can be a problem in that the incentives for both parties are not aligned.
Thank you for sharing your thoughts!
How is quality quantified in terms of doctor compensation
Good question. Different metrics by specialty.
@@ahealthcarez I heard that a problem of quality based systems that use patient outcome as a metric is
That doctors try to avoid difficult cases and risky cases
Any research on this?
God save us
Thank you for your comment.
Do you subscribe to any of Clarivate solutions?
I do not.
@@ahealthcarez but do subscribe to proforma and others?
I believe they're paid incentives for referrals
Illegal per the Stark Law, but that does not stop it from happening.
I have had hormone issues that cause inflammation all over my body. I have to wait 6 months to see a endocrinologist. Just to get my T4 treated. But I will not get tested for T3. Many women are not getting tested for T3. We are suffering from low Thyroid and it can cause premature death. Do doctors secretly keep treatments that work from us? I have been on this roller-coaster for 11 years. Adhd meds did help me, but now their is a national shortage of them. Only one Thyroid medication for women. One size fits all. Or surgery to remove the whole Thyroid. Men get testosterone therapy and live full lives. But if you mention anything about it as a woman, you are ridiculed and shamed. Movie stars, sports figures have access to all these hormones and performance drugs. All the while, women are suffering from autoimmune Thyroid issues that have them bedridden.
Exposing the truth
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