6 Metrics to Engage Physicians in Value-Based Payments

Thursday, May 22nd, 2014
This post was written by Cheryl Miller

As incentive models change for physicians and their practices along with the industry’s move to value-based care, it is key to engage them in the evolving process, says Cynthia Kilroy, senior vice president of provider strategy and business development at Optum. After you find a common value-based vision, you need to spend time with the physicians discussing what value-based care is, including how it is going to impact them, and what it means for their practice, among other things.

When you think about engaging physicians, which is how we typically roll this out across organizations, six key performance metric steps are needed to move this along. This is not something that happens in a couple of months. It takes one to three years to move a compensation model to a large 20 to 25 percent of incentives.

After you find the common value-based vision, you need to spend time with the physicians discussing what value-based care is, including how it is going to impact them, what it means for their practice, how we support them, etc.

Once you have alignment with that, the finding and designing of incentive metrics has to be done by the physicians. This cannot be done in a vacuum. It needs to be physicians from all different types of practices or specialties and different locations within the organizations that you look at. What are the incentives I want to measure?

Then you publish the incentives and blind those incentives so that physicians can digest and challenge them. Something may need to be modified. Therefore, you should give that time and feedback. Once you have that feedback, you can unblind it. Organizations find unblinded incentives to be a very powerful tool, but you need to make sure that you have the alignment and agreement and that people believe in the metrics, because if you put metrics out that are incorrect or not of value, you have lost the opportunity to change that behavior.

Then you create a shadow incentive reimbursement model, letting physicians know where and how it is going to impact them, allowing them to potentially change how they are practicing or leveraging the care team more.

Finally, you implement the incentive compensation model. There are two phases. One is to meet the minimum, which is typically the first way that the incentives compensation is executed. The next is a rating factor around the quartile, and that is something that takes time as well.

Next is the analytics platform. When finding, designing and publishing the incentive metrics, you build them, share them, get feedback and then approve the metrics. You need an analytic platform to understand and measure these new metrics that we are looking at.

Excerpted from 6 Value-Based Physician Reimbursement Models: Action Plans for Alignment, Analytics and Profitability.

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