Physician leaders: Docs must be accountable for costs for care, quality

Most top physicians believe doctors should be held accountable for costs and quality of care, according to a recent survey of chief medical officers and senior-level medical executives from a range of organizations and practice settings.

More than two-thirds (69 percent) of the 2,398 physician leaders surveyed by the American Association for Physician Leadership (AAPL) and the Navigant Center for Healthcare Research and Policy Analysis said they support the federal government's plans to reward or penalize doctors for quality and cost of their performance.

The findings were a surprise to Paul Keckley, Ph.D., managing director at Navigant, because physicians often balk at being held accountable for costs of care, since they don't have control over charges for tests, procedures and medical devices.

"It's a good thing that leaders are seeing the need for accountability, but this is certainly going to spark some pretty interesting tension at home," he said in a survey announcement from the AAPL.

"If leaders think their rank-and-file members need to be held accountable for costs, we had better quickly come to some consistent methodology for determining how a clinician is to know what costs are, and then a methodology for incenting them for lower cost and protecting them from frivolous lawsuits (if they deny care to control costs)," he added.

The survey findings will be released in three parts and examines physicians' attitudes toward healthcare reform, physician leadership competencies and the move from fee-for-service to value-based care payment models.

The initial survey findings also indicate that 55 percent of respondents believe the Affordable Care Act is "more good than bad."

Keckley said the finding reflects the fact that physician leaders understand that America's healthcare industry as it currently operates is unsustainable. "I suspect they see a bigger picture than most rank-and-file physicians, and if you are exposed to a bigger picture, you come to two conclusions pretty fast: Something has to change and maybe there are a number of strategies that could be employed to change the system," he said in the announcement.

Peter Angood, M.D., president and CEO of AAPL, added that "physicians want what is best for their patients, so as they review the ACA, I think they resonate with how the good aspects of the bill can improve healthcare."

Additional findings from the survey include:

  • 57 percent of respondents agree or strongly agree that accountable care organizations will become a permanent model for risk-sharing with payers
  • 63 percent of respondents disagree or strongly disagree that "the elimination of fee-for-service incentives in favor of value-based payments will hurt the quality of care provided to patients"
  • 58 percent of respondents agree or strongly agree that transparency about physicians' business dealings is a positive trend for the profession

To learn more:
- read the survey
- here's the announcement

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