Details and Context of New Payment Models Are Critical to Efforts of Physician Practices to Improve Care
Mar 19, 2015
The project reported here aimed to describe the effects that alternative health care payment models have on physicians and physician practices in the United States. Project findings should help guide efforts to improve current and future alternative payment programs and help physician practices succeed in these new payment models. The report provides both findings and recommendations.
Does not include Appendix B.
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The project reported here, sponsored by the American Medical Association (AMA), aimed to describe the effects that alternative health care payment models (i.e., models other than fee-for-service payment) have on physicians and physician practices in the United States. These payment models included capitation, episode-based and bundled payment, shared savings, pay for performance, and retainer-based practice. Accountable care organizations and medical homes, which are two recently expanding practice and organizational models that frequently participate in one or more of these alternative payment models, were also included. Project findings are intended to help guide efforts by the AMA and other stakeholders to make improvements to current and future alternative payment programs and help physician practices succeed in these new payment models — i.e., to help practices simultaneously improve patient care, preserve or enhance physician professional satisfaction, satisfy multiple external stakeholders, and maintain economic viability as businesses. The report provides both findings and recommendations.
Model, Background, and Methods
Background: Scan of the Literature on Effects of Payment Models on Physician Practice
Changes in Organizational Structure
Changes in Practice Operations
Increased Importance of Data and Data Analysis
Interactions Among Payment Programs and Between Payment Programs and Government Regulations
Physician Incentives and Compensation
Physician Work and Professional Satisfaction
Factors Limiting the Effectiveness of New Payment Models as Implemented
Advisory Committee Members