Physicians may not be happy that Medicare is shifting its emphasis away from fee-for-service toward fee-for-value. But financial incentives would help.
Of course, this presumes that physicians are aware that Medicare is changing its reimbursement methodology, especially as spelled out in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). (See May 2016 Repertoire.) Turns out, many aren’t.
Eight in 10 physicians surveyed by the Deloitte Center for Health Solutions said they prefer traditional fee-for-service or salary-based compensation, as opposed to value-based payment models, some of which qualify under MACRA’s alternative payment model (APM) track. However, 71 percent said they would accept value-based payment models, mostly shared savings, for a 5 percent guaranteed increase in payment.
The Deloitte Center for Health Solutions “2016 Survey of US Physicians” is a nationally representative sample of 600 primary care and specialty physicians who were asked about a range of topics on value-based payment models, consolidation, and health information technology. This year, Deloitte queried a subsample of 523 physicians (nonpediatric specialties) about MACRA.
Fifty percent reported they had never heard of the law, and 32 percent recognized it by name but were not familiar with its requirements. Twenty-one percent of self-employed or independent physicians said they were somewhat familiar with the law, compared to 9 percent of physicians employed by hospitals, health systems, or medical groups owned by them.
Fifty-eight percent of responding physicians said they would opt to be part of a larger organization to reduce individual financial risk and have access to supporting resources and capabilities. Specifically, 39 percent reported being more likely to accept risk-based compensation if they were part of a larger organization that lowered individual physician risk and took on risk for the group. Thirty-six percent said they would be more likely to accept risk if they were part of an organization that provided a full spectrum of resources for all clinical and nonclinical activities.
Lessons for suppliers
Medical technology and pharmaceutical suppliers may start to feel pressure from health systems and physicians to demonstrate improved product cost-effectiveness, says Deloitte in its report.
“Such pressure will likely emanate from growing provider consolidation and improved purchasing power. Life sciences companies should consider using this opportunity to develop more value-based contracts to help physicians and health systems achieve financial and outcome goals. It will likely be increasingly important to provide evidence of product cost-effectiveness; companies should consider the potential impacts on how they invest in and conduct research and development.”
Suppliers should consider strengthening relationships with physician practices and health systems to support the shift to value-based collaboration, says Deloitte.
To view the Deloitte Center for Health Solutions “2016 Survey of US Physicians,” go to http://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-are-physicians-ready-MACRA.pdf