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.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]