Value-Based Payment

The search for the “payment” unicorn continues.  A new report calls for moving from a volume-based to a value-based physician payment system.   Really?  Sounds so good but what does it really mean?    I could be perfect and spend all the time in the world with 10 patients a day but where do the other patients go if they can’t get in?   Here is what Charles Davant MD, who sent me the linked article, said:
So they want value over volume? Ain’t going to happen. PC’s will be on maximum overload. Reward me for quality and I can retire at my desk. Pay me to bust my butt and I’ll deliver 90% of the needed quality to twice as many patients, and the 10% I miss I’ll get the next time they are in the office.”
The only model I have seen work where you can spend all the time you need with patients and not even bill their insurance is the direct-pay model.  And since you have one-third the patient panel as an employed family doctor, no one is clamoring to get in.   By the way, just expanded to a third physician as the first two are filled or filling up.
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