Physician incentive helps access, prep for new pay models

In Massachusetts, where physician access is notoriously tight, primary care physicians at Massachusetts General and Brigham and Women's hospitals are adding patients for the first time in years, thanks to financial incentives offered by Partners HealthCare, the parent organization of the two Harvard-affiliated hospitals.

Under the program, which started last year, the hospitals' 360 employed PCPs have 10 percent of their salaries tied to the size of their practice and the complexity of their patients' illnesses, The Boston Globe reported. The incentive, which was at 2 percent last year, has gotten mixed reactions from physicians who are overwhelmed but nonetheless welcoming of the extra compensation.

Some Mass General doctors, for example, have not told the hospital hotline, which gets about 200 requests weekly for PCPs, that they've opened their practices but have continued to add one to two patients per week by word of mouth alone.

To help shoulder the workload, as well as promote a team-based model of care, the hospitals plan to hire more physician assistants and nurse practitioners.

The Commonwealth's test has national implications. According to the article, the initiative will not only help improve access to care, but it will also help physicians prepare for emerging payment models, which represent a dramatic shift from the fee-for-service environment to which they're accustomed. The experiment may present some challenges, as most providers in the state favor fee-for-service reimbursement because it pays them for "what they do," even though they recognize its inherent limitations, according to a recent paper on physician payment reform published by the Massachusetts Medical Society.

To learn more:
- read the article from the Boston Globe (subscription required)
- see the post from White Coat Notes