Docs treading lightly with new payment models


Surprising way a group of surveyed physicians are saying what they think is the best way to control costs.

In the midst of industry development of new payment and delivery models to improve efficiency and help control costs, physicians are cautiously optimistic that these new payment models may contribute to a higher quality of care and improved patient outcomes, according to a recent survey.

The survey, from Fidelity Investments and the National Business Group on Health (NBGH), found that the majority (59%) of primary care physicians (PCPs) believe that the current fee-for-service model is not aligned with quality care.

The survey, which was released just prior to the Alternative Payment Models in Healthcare Conference 2016, held in Orlando, Florida, March 17 and 18, asked 500 practicing physicians about emerging payment and delivery systems, and views on the current payment model.

“Physicians appear to be hesitant about whether recent efforts to reform healthcare reimbursements and improve patient care have worked,” says Karen Marlo, vice president, benchmarking & analysis, at the NBGH. PCP survey takers rated those efforts an average of 4.6 out of 10 in terms of their success.

When asked for the top three ways to control costs, responding physicians indicated that the top method would involve better coordination of care (62%).

This was one of the more interesting findings, according to Marlo. She says that although PCPs believe one of the best ways to control healthcare costs is coordination of care, it varied significantly by the age of the physician, with younger physicians leaning heavily toward coordination of care as the best method compared to liability reform for physicians over age 55 years.

Next: Other ways physicians recommend controlling costs



Other ways physicians recommend controlling costs

Other common methods included: liability reform (56%), improving patient’s lifestyles (53%), changing how physicians and hospitals are paid (44%), and improving the quality of care patients receive (38%).

More than 55% of PCPs currently participate in some kind of alternative payment model. A full third of PCPs already participate in some type of pay-for-performance payment arrangement, and another 22% are willing to participate in the future.

According to the survey, 32% of PCPs currently practice inside of a patient-centered medical home and another 22% would be willing to do so in the future. Twenty-nine percent of responding PCPs participate in an accountable care organization, and another 16% would be willing to do so in the future.

“As health plans continue to invest in alternative payment models, it is important to understand the mindset of physicians, particularly primary care physicians,” Marlo tells Managed Healthcare Executive. “PCPs are a critical component of the healthcare system as they influence a large portion of other care, such as use of specialists. Without the support and buy-in of PCPs, these models will not be successful.”

Marlo believes this survey mirrors what is happening on a national level.

“There has been significant interest by private payers as well as public payers about paying for quality and outcomes, rather than just reimbursing for services,” she says. “Yet, the physician is instrumental and health plans must understand physician viewpoints in order to create a system that will succeed.”

However, the physician mindset won’t change overnight, Marlo says. “These alternative payment models require significant investment by physicians.”

As a result, executives need to:

1. Understand that it will take time for full physician buy-in. But there is reason to be cautiously optimistic about the changes in the payment system, she says.

2. Ensure any alternative payment model accurately reflects the investment physicians are making in their practice.

3. Determine how to best support practices as they change the way they practice medicine.



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