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Can value-based care damage the physicians’ practices?

Can value-based care damage the physicians' practices

Around 51% of physicians in the survey claim that value-based care and reimbursement would negatively impact patient care. There is no clarity about the thought of probable effects of the value-based model that will pose on the physicians’ practices and patient care thereby. As per the survey, it has been suggested that value-based care and reimbursement might negatively affect collectively on patient care.

The following are the probable consequences of value-based care and pay for performance models…

  • Create pressure negatively on the lowering rates of claims’ reimbursements.
  • Need for more expenses on the ongoing services and collaborations to enhance success areas with quality assurance.
  • The strain on resources and cost due to extra documentation and data collection with added analysis.

Many physicians may not get fairly compensated for their performance due to unclear metrics in the pay for performance model. As there is the unavailability of adequate metrics for accurately measuring pay for performance and it would ad on as one more reason for payers to hold on grip towards the reimbursements for physicians.

A coordinated group of physicians, hospitals and organizations that aim towards delivering high-quality care and receive value-based reimbursement for the cost and quality of care they provide are accountable care organizations (ACOs). Also, the participation of some physicians in ACOs was not that assured, as some of them did not want to participate or were doubtful and most of them needed more information to decide. Clear denial in participation was shown by older physicians specifically.

Physicians might withdraw their participation from bundled payments and ACOs probably as they believe that the alternative payment models restrict their practices from patient care. The rules and guidelines of such bundled models and care payment programs drive their attention just towards meeting the protocol rather than the needs of the patient care.

Value-based sources of payments are not only the one uncommon source of physician compensation, but the performance-based lowered compensation is also one of the reasons

What needs to be considered?

  • ACOs or other organizations employing physicians that work towards value-based care need to think of aligning their and physicians’ incentives together.
  • The percentage of compensation tied to the performance-based goals should be at least 20%.
  • This may assist the physicians’ buy-in initiating towards value-based care and to amplify their efforts towards more effectiveness in cost and quality. 
  • This can be achieved by individual assessment of goals set and performance and compensation achieved by each physician. There has been active participation and open communication amongst all physicians to keep a track of working on strategies to accomplish effective compensations.
  • They also need to broaden the scope of current protocols to canopy maximum possible patient conditions; to increase the relevancy of protocols for many other special conditions that are not currently heeded upon. 

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