The Future of Reimbursement for Physicians
Matt Robbins, Senior Director of Recruiting, Delta Physician Placement
As healthcare expenditures continue to increase, physicians are facing new trends related to how they are paid for the care they provide. Accountable care organizations, meaningful use, value-based reimbursement, core measures and HCAHPS scores are terms rolling off the tongues of physicians and practice management consultants across the country.
A new trend takes root
Over the past couple of years, a trend has emerged that indicates physicians will soon be paid, at least in part, based on the value they deliver rather than simply on how many patients they see or the number of procedures they perform. According to a recent report in American Medical News, large insurers including UnitedHealth Group, WellPoint and Aetna are already beginning to reimburse physicians with incentives that are based on quality and efficiency measures. Medicare is doing the same through accountable care organizations, commonly referred to as ACOs.
Recently, there has been a slight uptick in the number of physician employment contracts that include some type of value-based bonus system. Most of these agreements still maintain productivity as the main component of the compensation formula, but increasingly we’re seeing incentive compensation that also incorporates value-based components, such as quality measures, outcomes, efficiency and patient satisfaction.
Large health systems and organizations in major metropolitan areas have been the early adopters of these value-based reimbursement contracts, but we expect the trend to spread to smaller markets relatively soon. Rural areas may be slower to adopt the new value-based compensation formulas depending upon what type of health record system they have in place.
Increased transparency and accountability
As more hospitals and organizations convert to sophisticated electronic health record systems, better data related to quality and outcomes will become available. This, in turn, will result in a greater demand for transparency on the part of healthcare providers, including hospitals and physicians. Patients can already log on to quality indicator websites such as the Department of Health and Human Services’ Hospital Compare to get up-to-date information they can reference when making decisions about buying healthcare.
As has been the case with past significant changes in the way physicians are reimbursed, these new trends are causing practitioners to spend time reviewing the business side of their practices. Currently, we are seeing contracts that call for only 2-5 percent of a doctor’s income to be based on cost control, quality, and/or patient satisfaction measures. Also, the insurance companies that are adopting value-based reimbursement are doing so in a gradual manner.
The doctors who fare the best in the face of these new reimbursement methods will be those who focus their attention on delivering the best possible patient care, while at the same time, being mindful of the cost of that care. Good communication skills and the ability to maintain positive relationships with the individuals they care for will become even more important as doctors partner more closely with their patients to create the best possible health outcomes.
Reimbursement models continue to evolve at a rapid pace and, often, what is true in today’s industry may not be accurate a year from now. It is still important to be aware of trends as they occur. Physicians who make an effort to understand and keep abreast of developments related to reimbursement will be in the best position to respond and adapt to changes as they occur.
Placements & Interviews
Placement Data by Specialty
This data represents average statistics of placements and interviews by Delta Physician Placement over the twelve-month survey period. Since these averages only include placements and interviews, the compensation information presented indicates the rate at which candidates are choosing to interview or sign. Average days information can be used to forecast a probable timeline for a recruitment effort in a particular specialty.
|Average Compensation||Average Days|
|Starting Compensation||Sign-on Bonus||Total Annual Compensation||From Interview to Placement||Total Placements||Fastest Days-to-Fill|
|Oncology ||$456,555 ||$50,000 ||$501,111 ||40 ||103 ||41 |
Placements by Population
Nationwide Search Distribution
Specialty Demand Comparison
|1st Quarter 2012||1st Quarter 2011|
|1.||Family Medicine ||Family Medicine|
|2.||Internal Medicine||Internal Medicine|
|4.||Emergency Medicine||General Surgery|
|13.||Orthopedic Surgery||Pulmonary Critical Care|
|14.||Pulmonary Critical Care||Hospitalist|
|15.||Family Medicine/Obstetrics|| |
Search Specialty Distribution
|Top 5 States Providers Have |
Taken New Opportunities
|Specialty||Number of Days|
Nationwide Physician Distribution
|Lowest Average |
to Close Credentialing
|Number of Days||Highest Average |
to Close Credentialing
|Number of Days|
to complete a file