Physician compensation structures have mirrored healthcare insurance, reimbursement and payment designs during the past decade, and are complex, variably interpreted and difficult to unpack.\u00a0 The results are highly variable compensation structures, often not firmly based on reliable data or well defined quality, safety and efficiency measures.\u00a0 In addition there is a large difference between the lowest and highest earning Physicians.\u00a0 In our health system, this difference is 4X for employed Physicians, and as much as 10X for independent Physicians.<\/p>\n
In order to address some of these issues our health system (18 Hospitals in both urban and rural settings) is undertaking a comprehensive redesign of Physician compensation.\u00a0 The current task force approach is to reduce complexity, increase reliability of metrics, drive equity and align incentives.\u00a0 Initial focus will be on the employed Physician group, followed by PSAs (Professional Services Agreements; comprehensive contracts with independent Physician groups), and finally influence peddling with other Physician contracts.<\/p>\n
We have looked at single payor systems in Europe for Primary Care and Specialty payment designs, as well as metrics for individual assessment of performance.\u00a0 Large Physician owned multispecialty groups in the U.S. have excellent, but often overly complex KPI metrics.\u00a0 Health insurance companies have lots of data, but are unwilling to share much that is meaningful.\u00a0 Most elusive is how to reduce compensation inequity, as this necessarily involves increasing pay for low earners, and decreasing income for high earners.<\/p>\n
Anyone else out there grappling with these issues? (I know from another post that some group is at least tackling salary versus incentive compensation and the resulting motivational differences)<\/p>\n
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Physician compensation, like healthcare payment structures, has become complex, cumbersome and contentious. What is the Venn diagram intersection of reality, equity and ego?<\/p>\n","protected":false},"author":12198,"featured_media":0,"comment_status":"open","ping_status":"closed","template":"","categories":[],"class_list":["post-645","hck-submission","type-hck-submission","status-publish","hentry"],"connected_submission_link":"https:\/\/d3.harvard.edu\/platform-mhcdsolutions\/conversation\/mhcd-solutions\/","yoast_head":"\n