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Volume-Based Compensation Most Common Incentive for Doctors

Quality and cost performance incentives were common, but percentage of compensation based on these was modest

MONDAY, Feb. 14, 2022 (HealthDay News) — The most common base compensation incentive component for primary care physicians (PCPs) and specialists is volume-based compensation, according to a study published online Jan. 28 in JAMA Health Forum.

Rachel O. Reid, M.D., from the RAND Corporation in Santa Monica, California, and colleagues characterized PCP and specialist compensation arrangements among U.S. health system-affiliated physician organizations (POs) in a cross-sectional mixed-methods analysis of in-depth multimodal data from 31 POs affiliated with 22 selected health systems in four states.

The researchers found that the most common base compensation incentive component was volume-based compensation for PCPs (26 POs; mean, 68.2 percent of compensation) and specialists (29 POs; mean, 73.7 percent of compensation). Quality and cost performance incentives were common (included by 83.9 to 56.7 percent of POs for PCPs and specialists, respectively), but only a modest percentage of compensation was based on quality and cost performance (mean, 9.0 and 5.3 percent for PCPs and specialists, respectively). The most commonly cited action for physicians to increase compensation was increasing the volume of services, which was reported as the top action by 22 POs for PCPs and specialists.

“For the U.S. health care system to truly realize the potential of value-based payment reform and deliver better value for patients, health systems and provider organizations will likely need to evolve the way that frontline physicians are paid to better align with value,” Reid said in a statement.

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