Value Based Payments for Physicians
H.R.2 – Medicare Access and CHIP Re-authorization Act of 2015 was passed by the House on March 26, 2015 and the Senate on April 14, 2015. While the title of the law indicates one of the topics of the bill (removing the sustainable growth rate (SGR) methodology from the determination of annual conversion factors in the formula for payment for physician services), the title is not representative of a major change that could affect all physicians. Under the Medicare Access and CHIP Reauthorization Act of 2015, the Secretary of Health and Human Services is directed to consolidate components of the three specified existing performance incentive programs into a new Merit-based Incentive Payment (MIP) system under which physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists, would receive annual payment increases or decreases based upon their performance as measured by standards the Secretary shall establish according to specified criteria.
Additionally, the Government Accountability Office (GAO) is directed to examine similarities and differences in the use of quality measures under the original Medicare Fee for Service program, Medicare Advantage Program, selected state medical assistance programs (Medicaid), and private payer arrangements and make recommendations on how to reduce the administrative burden on applying such measures.
The pace of changing from fee for service to value based payment models is likely to accelerate in the next coming 1 to 3 years. It is critical when considering an incentive payment structure to do two things – (1) review lessons learned and (2) complete a baseline assessment of your practice. Numerous lessons have been learned from Accountable Care Organization providers and providers who are participants in Value Based Programs. These lessons are critical to review before entering into incentive based programs. Additionally it is important to complete a baseline measurement for applicable quality measures and review possible methods of improvement prior to making a contractual commitment.
Authored by Valerie Shahriari, Florida Healthcare Law Firm Blog
Medscape Physician Salary & Satisfaction Survey Results
Medscape has released the results of their 2013 physician salary and satisfaction survey. They’ve been doing this for the past 3 years and the results are interesting and informative. The data comprises information from 21,878 physicians across 25 medical specialties regarding the 2012 fiscal year. I cherry picked some key points I thought you might find interesting for the Anesthesiologist community:
- Anesthesiology was the 6th highest compensated specialty in 2012 at $337,000. The 3 top earning specialties were: orthopedic surgery ($405,000), cardiology ($357,000), and radiology ($349,000).
- Anesthesiologist experienced an average of 5% increase in income in 2012.
- Board certification contributed towards an increase in compensation of $101,000.
- Only 47% of Anesthesiologist said that they were overall satisfied.
- 55% said that they were fairly compensated.
- Only 39% said that they would choose Medicine as a career again.
- Only 46% said that they would choose Anesthesiology as a specialty again.
- The two most rewarding parts of the jobs were: patient interaction and diagnosing patient problems.
I think the most telling survey finding is the drop in satisfaction levels of all physicians and Anesthesiologists in particular. It’s hard to determine the source of the dissatisfaction, however; given the shear amount of chance interjected into the healthcare system by the Affordable Care Act, it is no wonder that healthcare providers are unhappy because of the unknowns that exist.
To view all of the Medscape survey findings in a slideshow format, click the link below:
http://www.medscape.com/features/slideshow/compensation/2013/public
