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Despite shift to value-based care, hospitals still paying doctors with fee-for-service expectations, AMA says

A quick breakdown of the different approaches hospitals are taking to compensate physicians amid the massive shift from volume to value.

Jeff Lagasse, Associate Editor

The shift from fee-for-service payment models to those based in value has been occurring steadily over the past few years. Increasingly, providers are determining physician pay through a number of different means. But what does that mean for the ways hospital pay doctors? And what approach are your competitors taking? 

The options include straight salary, compensation based on personal productivity (as has been the case in a fee-for-service world), bonus structures and tieing pay to an organization's overall financial performance.

[Also: Expert tips for incentivizing physicians to embrace value-based care]

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Salary is the most common model at 52.5 percent, while productivity still accounted for 31.8 percent. Only 9 percent was based on the practice's financial performance, meanwhile, and bonuses comprised 4.1 percent, according to an American Medical Association analysis.

Here's where the plot thickens a bit. "Over half of physicians (54.4 percent) indicated that their compensation was based on more than one method, greater than what was observed in 2014 and 2012," AMA said. 

Productivity was a greater chunk of compensation for private practice owners, at 44.7 percent; that number dipped to 22.3 percent for employed physicians.

Partly that's because employed physicians were more likely to have a salary, decreasing the need for productivity to factor into their overall compensation equation, the AMA said. The group said some physicians are likely feeling pressure to increase their productivity by doing things like increasing their patient volume, or hiring outside help to perform more menial tasks.

It's worth noting that while the AMA just published the findings, they are based on surveys conducted during September of 2012, 2014 and 2016 with approximately 3,500 respondents each year -- and a lot has happened in value-based care since then. 

"We also find evidence that the use of multiple methods to determine physicians' overall compensation has been on the upswing," AMA said.

Twitter: @JELagasse
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