Just 3% of primary care physician compensation comes from quality measures. The rest? Productivity.
There's plenty of talk about outcome-based reimbursement, accountable care and otherwise preparing for a healthcare economy based on quality and health, not productivity and sick care. And that is clearly where things are headed.
But pay for outcomes isn't here yet.
So primary care physicians are in a tough spot, asked to focus on chronic disease outcomes and population management, while actually getting paid for volume. It's hard to focus on wellness while handling 40 to 60 sick patients a day.
There's new evidence that reimbursement isn't keeping track with rhetoric: According to the MGMA Physician Compensation and Production Survey: 2013 Report Based on 2012 Data, primary care physicians report that 3% of their total compensation is based on measures of quality. Specialists? Just 2% of their compensation is quality based. The money just isn’t there yet. For physicians, practically speaking, it’s all still about sick care and doing as many visits or procedures as possible.
A new HFMA study finds the same: Although 72% of the hospitals surveyed said their main goal in employing physicians is "improved care coordination," they don't pay that way. Hospitals aren't paying physicians mostly for improved care and outcomes. Rather, 77% of current physician agreements are based on producitvity or volume, according to HFMA.
Outcome-based payment will come. “Quality and patient satisfaction metrics are not yet dominant components of physician compensation plans right now. However, as reimbursement models continue to shift, the small changes we’ve observed recently will gain momentum,” as Susan L. Turney, MD, MGMA-ACMPE President and CEO, puts it.
But for now, you'll need to pump out volume.