3 models to align doc employment and value-based incentives

An increased emphasis on high-value care delivery means healthcare needs new strategies to align doctors and system-wide incentives.

While the accountable care organization model is often touted as the wave of the future, gains may not be large enough to drive the volume-to-value shift on their own, according to an Advanced Journal of Managed Care article.

To better align physician incentives and value-based care models, healthcare leaders have three options--all which require physicians to receive performance feedback in order to provide high-quality care, according to the piece:

Employment-based health systems, which have the advantage of a managerial relationship between the hospital and doctors, and allows organizations to rely on non-financial alignment strategies such as design, staffing, information-sharing and standardized processes. This model also encourages frequent contact between doctors and hospital leaders.

Network-based health systems, such as clinically integrated networks, which tie physicians together tighter than contracts. This model may create the need for stronger individual financial incentives and must also align with doctors’ values to keep up morale, a concern raised in a recent Annals of Internal Medicine study. The authors also suggest non-financial incentives such as “social norming,” to improve performance. In addition, the article recommends hospitals that use this model make sure payments track directly with unblinded rankings and employ multiple thresholds to engage lower-performing physicians.

Contract-based health systems, where both financial and nonfinancial incentives are difficult to implement effectively, creating the need for vigorous quality profiling. Leaders operating under this model must use precise quality measures in areas such as patient experience and care access.

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