The shift to value-based care reimbursement continues slowly and incrementally, writes Bruce Japsen in Forbes, which means doctors will increasingly see the effects on their income.

The number of doctors who receive production bonuses for meeting value-based metrics has risen to 29 percent, according to a recent survey from the physician staffing firm Merritt Hawkins. Fee-for-service (FFS) payments still deliver the bulk of overall physician compensation, despite value-based remuneration rising to 6 percent of total pay.

Doctors and industry experts generally agree that the traditional FFS model doesn't align incentives properly to ensure doctors deliver (and get paid for) care that leads to higher-quality, more efficient care for individuals or overall populations, as FiercePracticeManagement has previously reported.

While the Centers for Medicare & Medicaid Services push through major changes to the government's reimbursement policies via the Medicare Access & CHIP Reauthorization Act (MACRA), large insurers have developed plans that shift toward pay for quality even more quickly, according to Japsen. He also notes that insurers are working in concert with the government to develop and move to new care models aimed at improving quality metrics.

"Insurers tend to dangle more financial carrots before primary care doctors to improve outcomes, increase quality and keep patients away from hospital care and more expensive specialists," writes Japsen. This may explain why these trends are more pronounced among primary care practices, which saw a rise in quality-based compensation from 7 percent in 2013 to 11 percent in 2014, per the Medical Group Management Association. The group reportedly expects this trend to continue when it updates those numbers later in the summer.

- read the article

- here's the survey (.pdf)