Physicians feel sidelined in value-based care discussion

Many physicians feel sidelined in the healthcare industry's transition to value-based care. But doctors who feel included in the decision-making process are more likely to embrace change.

Bain and Company's Healthcare group surveyed about 1,000 physicians, and found that they were skeptical of value-based care. More than 70% said they preferred the more traditional fee-for-service model. 

The survey suggests that physicians understand the need to rein in costs and waste but don't necessarily feel that they play a role in that effort, two partners at Bain, Tim van Biesen and Josh Weisbrod, write in an article for Harvard Business Review. 

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Doctors want evidence that new value-based care models will actually improve clinical care, and failing to bring them on board is a major obstacle to successfully adopting and improving these programs, they write. 

"The only practical way to make value-based care a reality is for healthcare organizations to bring physicians back into the decision-making process," they write. 

Weisbrod and van Biesen note that one "bright spot" in physician engagement is in purchasing. Changes in that area highlight what can be done to better include doctors in decision-making, as surgeons who are more involved in buying equipment were more likely to be aligned with the missions of their organizations.

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Other research has suggested that physicians feel value-based care models may ask too much of them, and that the administrative work required is burdensome. The work is harder and often less satisfying, they said. 

A solution to potentially engage doctors in this transformation is to create incentives that allow doctors to share in the rewards of success instead of merely working to improve the organization's bottom line.