Ten Keys to Physician Retention
However, a growing number of physicians also are being compensated on such “value-based” metrics as patient outcomes, quality measures adhered to, use of healthcare information technology, cost effectiveness, and patient satisfaction. These measures are more subjective, less easily understood, and usually less well- received by physicians than are standard volume-based measures, which are comparatively easy to understand. It is important for healthcare leaders to follow evolving physician payment models and to ensure physician performance and pay metrics are as clear as possible. This entails keeping the number of metrics as low as possible and having evaluation measures be physician-directed and fair. For example, physicians who treat a high number of sick, problematic patients are unlikely to achieve patient outcomes as favorable as those achieved by physicians who treat mostly healthy, uncomplicated patients. It therefore is unfair to compensate these physicians by the same outcomes standards. Value-based compensation models also require tracking outcomes data, such as which physicians achieve low rates of diabetes or low blood pressure among their patients, which have low readmission rates, positive patient satisfaction scores and other benchmarking metrics. Buy-in is more likely when physicians are presented with physician-instituted quality standards and meaningful outcomes data. The “right” physician compensation formula is hard to come by, particularly when consolidation is taking place and physicians from various groups are joining a central system where compensation may be standardized. The “Goldilocks zone” in which physicians are rewarded sufficiently for volume to stay productive, yet also are rewarded enough on value to embrace new delivery models, is still aspirational for many healthcare facilities. Indeed, some large medical groups and other facilities have abandoned these types of compensation models due to the confusion and frustration they create among physicians, and have converted to the straight salary model.
Today, the general rule is, the simpler and clearer the physician compensation formula, the better.
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