This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.
I love a good stat. I realize that you can make stats tell you whatever you want. However, if you look at them with a critical eye, you can learn something about both the organization producing the stat and the population that the stat represents.
It’s no surprise that I found these MACRA stats shared by David Chou to be of great interest and a perfect MACRA Monday discussion.
— David Chou (@dchou1107) March 27, 2017
The stat that stands out to me is the 51% of physicians who reported that they weren’t getting paid on a performance basis or that their compensation had a very small performance based piece to it. For those of us following the cutting edge of what’s happening in the world of healthcare, it’s sometimes important to remember that while the shift to value based reimbursement is happening, it still has a long ways to go.
I found David Chou’s tweet with these stats interesting when he said “Most physicians prefer the old model of payment vs MACRA.” I would look at these stats a bit differently than David.
I would suggest that these stats say that doctors prefer reimbursement models they understand and ones that pay them well. This is proven out in the stat that 71% of physicians surveyed would participate in value-based payment models if offered financial incentives to do so. It’s not really a shocking insight that doctors are happy to shift models if there are financial incentives to do so.
The challenge is that most doctors don’t think that a value based reimbursement model is going to pay them more for the work they do. They’re probably right. This explains why nearly 8 in 10 physicians surveyed prefer fee-for-service or salary for their compensation. If a new model came along that would pay them more than their current fee for service model, then they’d happily switch models.
Sometimes we make things too complicated. Physicians just want to be paid well for the work they do. Sounds like all of us no? The concern for most physicians is that these models are unlikely to pay them more. In fact, it’s quite possible they’ll pay them less or at least pay them the same for more work.
I haven’t seen any plan or projections to pay doctors more. In fact, the rhetoric in society is that we pay too much for healthcare (which is true). As a society, we all agree that we should be paying less for healthcare. However, as a healthcare provider or healthcare organization the idea of paying less for healthcare translates to getting paid less. Who’s going to take the hit when it comes to getting paid less? Providers? Hospitals? Pharma? Med device companies? Health IT Companies?
Could value based reimbursement models theoretically cost less and pay all of these stakeholders the same amount of money because patients were healthier? Works great in theory, but looking at the past history of these programs tells another story. So, it’s no wonder that most doctors would happily stay in the fee-for-service reimbursement world they know vs moving to value based reimbursement models.
Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.