The headline “Physician Compensation Programs Move Toward Value-Based Pay” suggests that this is a fait accompli, and maybe it is. A broad survey showed “value-based incentive components in primary care compensation was up five percent from last year, with 62 percent of organizations incorporating these incentives into their physician compensation programs.”
Hmm. “The report found that value-based incentive payments remained small at 6.2 percent of total cash compensation (TCC) across all specialties studied. That percentage only increased from 5.6 percent in 2018.” So a small portion of total cash paid still gets a lot of ink. Why?
One source “anticipates more physician compensation to be tied to performance metrics, such as clinical quality, patient experience, and access, as new models of care focusing on population health support the transition from volume to value.”
Which means that more doctors’ paychecks will be tied to things over which they have no control. Contrarily, this source predicts “physician compensation in general to increase as the healthcare industry faces a growing demand for talent amidst a looming shortage of physicians.” Now why might that be?
The actuaries state “this demand continues to push physician compensation upwards without being supported by corresponding gains in productivity or reimbursement – resulting in higher levels of organizational investment per physician … there is a notable pressure on family medicine and internal medicine compensation without those changes in wRVU. In order to meet population health standards, organizations must add an extra measure of performance such as panel management and telehealth to their primary care scorecards.”
So why aren’t “organizations” pushing back against Big Insurance and Big Government to reverse this stupidity? Where is there any push back against this value-based scam? Yes, Direct Primary Care guerillas are out in the countryside creating what havoc they can, but the AMA, AAFP, et al are still the puppet governors of the cities, slapping up “Value Based!” propaganda posters on every crumbling brick wall.
I think organized medicine is more cynical that it is stupid, but in the end it doesn’t matter. They know (or ought to), as does government, and you and I, that the purpose of value-based compensation, with all its nebulous, pointless, and unenforceable metrics, is NOT population health. The entire point of this scam is to pay physicians less. If this results in government and crony-corporatist insurance companies tightening their grip on downstream health organizations, and turning physicians even more so into government agents, then that’s just gravy.