Imagine a world where you have no control of which patients come through your door. A world where you have no control over how your practice is run. A world where you still have to see 25-30 patients a day yet worry whether you are pleasing each and every one of them. A world where you can get in trouble if one out of 500 patients was not satisfied and decides to complain to the hospital administrator. A world where you can lose money because a patient ate himself into a heart attack or would not take her medication and her blood pressure was too high. Actually, we live in this world. Per this article in Forbes:
- Physician staffing firm MerrittHawkins said 43% of its clients offering physicians a “production bonus” last year based the bonus “in whole or in part on value-based metrics such as patient satisfaction and outcome measures.” That compares to 39% in 2016 and 32% in 2015, according to Merritt’s 2018 Review of Physician and Advanced Practitioner Recruiting Incentives.
- It’s a trend that others who analyze doctor pay are also noticing as health insurers including Anthem, UnitedHealth Group, Aetna and Cigna shift more than half of their reimbursement to value-based models that pay doctors based on quality of care delivered and the health outcomes of their patients.
- The Medical Group Management Association (MGMA) said its 2018 Datadive Provider Compensation report showed 25% of providers “having compensation tied to quality and patient experience metrics.” MGMA reported similar trend in a recent poll of doctors showing 26% had physician compensation tied to quality metrics.
You are basically a number to be analyzed. And if you do not satisfy patients enough then you will be punished. Unless you do Direct Primary Care or some type of cash practice (specialists) then as the article states, “it’s only a matter of time before physicians will see the bulk of their compensation tied to quality measures if current trends hold.”
- UnitedHealth Group, for example, reported earlier this year that nearly 60% of the insurer’s $130 billion in annual medical spending is value-based models.
- And Aetna, the nation’s third-largest health insurer, and CVS Health, the large drugstore chain, have promised more value-based reimbursement models once their merger is complete later this year.
- “In this digital age of instant gratification, medical practices need to take steps to remain competitive and keep their patients satisfied,” MGMA’s Fischer-Wright said in a statement to Forbes.
Imagine CONTINUING to practice in this world where many patients act like King Joffrey from Game of Thrones. Let me also remind you that the only evidence on these quality indicators and metrics shows that it DOESN’T work! Let me also remind you that every organization that represents us in some manner (AMA, AOA, AAFP, ACP, etc) all support “working” with these groups and value-based reimbursement models.
The time to revolt is now before it is too late because it may be.