Can putting just small amounts of physician compensation at risk under value-based payment schemas actually change physician behaviors? That seemed to be a question hanging in the air as the Englewood, Colo.-based Medical Group Management Association (MGMA) released its annual survey on physician compensation on July 1.
As we reported here, the largest national association of medical group leaders found this year that “Primary care physicians (who indicated that they were not part of an accountable care organization or a patient-centered medical home) reported that an average of 5.96 percent of their total compensation was based upon measures of quality. Specialists,” the report found, “reported that an average of 5.70 percent of their total compensation was tied to quality metrics. Some specialties, including anesthesiologists, internists and hospitalists, reported that a higher percentage of their total compensation was tied to quality metrics. MGMA surmised that physician compensation would increasingly be tied to these metrics as reimbursement aligned more closely with quality and cost measures,” the press release announcing the survey results noted.
The thing is, of course, 5.70 percent and 5.96 percent sound pretty darned low in the abstract, don’t they? It means that more than 94 percent of the compensation of survey respondents remained value-based at the time they answered the survey questions. And that’s a lot.
But there is quite another way to look at this scenario as well. As these levels of compensation continue to shift, even small percentages are going to make a difference. What’s more, the primary care physicians responding to this specific question are those who had indicated that they are not currently participating in ACOs or patient-centered medical homes—and many, many physicians are doing so.
In other words, at a time when a strong plurality (and soon a majority) of physicians are already participating in ACOs and PCMHs, when those not doing so are seeing their compensation shifting towards value-based payment, it’s clear that the overall physician market is changing in the U.S. (and many would add, “It’s about time”!).
All of this also means that practicing physicians in the U.S. are going to be relying more than ever on a variety of information systems and types of data to practice medicine. They will need dashboard-type clinical performance data in as close to “real-time” as possible; they will need to better understand their patient panels; they will need, more than ever before, to understand the broad dynamics of their medical groups and other patient care organizations, in their local and regional markets; they will need to be able to quickly understand and interpret the cost savings they’ll be expected to regularly deliver in ACO, bundled-payment and other systems; and they will need the ability to receive, ingest, and analyze their overall practice patterns in ways that will be more subtle than ever before.
Given all that, there is no question that healthcare IT leaders in hospitals, medical groups and health systems will be on call as never before to help physicians in practice achieve all the goals being laid out for them in the new healthcare. And we’re on the verge of reaching a true inflection point here: looking backwards just a few years ago, many American doctors were still resisting data-driven, performance-driven, accountable healthcare delivery and payment systems. All that is quickly shifting, and the new realities are coming into place as never before. But with the shift is coming a level of dependence on data and IS that is also unprecedented.
So, CIOs, CMIOs, CMOs, and others: the days when the doctors avoided you are quickly giving way to the days when they’ll be knocking your doors down to get the best, cleanest, most robust data—stat. And this shift is happening more quickly than any of us could have imagined. So there’s no time to waste.