Efforts to pay physicians for quality outcomes face challenges—such as complex compensation models, poor alignment of goals and lack of clearly defined measures—that can result in failed efforts. Thus, adoption of pay-for-quality programs for physicians has lagged.
Even primary-care physicians participating in accountable care organizations, which are designed to increase care coordination and reduce costs, continue to have nearly half their pay linked to productivity, while only about 3% have it tied to quality, said Andrew Ryan, a University of Michigan health policy researcher. He co-authored a study published last week in the Annals of Family Medicine that found large variations in compensation across physician groups that share risk and those that do not. The authors said that likely reflects a lack of consensus about the most appropriate ways to pay the doctors.
“We need to figure out the barriers that are causing payment reform not to actualize its full potential,” said Mark Zezza, an assistant vice president at the Commonwealth Fund. The not-for-profit will host a webinar on value-based pay on Thursday for leaders of provider organizations.
The aim, Zezza said, is to share strategies from 16 organizations with innovative programs for paying doctors based on quality. Some have made “quality pay” a separate line item on doctors' paychecks, while others give doctors separate quality bonus checks in front of their peers during quarterly meetings. There isn't systematic research that says “this is the best way to do it.” But there's a lot that can be learned from organizations that are experimenting with different methods, Zezza said.
