I work for a large multidisciplinary medical group that provides clinical care for a significant portion of our community. Our medical group is a part of a large independent academic health center and we are closely aligned with the system’s goals of population health and partnerships with payors and ACOs. Specifically, our providers and practices partner with an Accountable Care organization that have upside risk contracts for Medicare patients and have been heavily involved in discussion on how to reduce patient costs.
Our health system has also heavily invested in the concepts of Provider happiness and have recently created an Office of Provider Wellbeing that focuses on reducing burnout and assuring joy in work. The primary drivers of provide dissatisfaction are EMR usage, and lack of protected time for professional development, academic work and teaching.
Finally, we are feeling pressure from our Corporate Finance partners to increase the clinical efficiency of our practices by increasing volume and decreasing staff expense. The Finance team have been very collaborative partners with operational and clinical leaders in doing this work and ensuring the continued high quality nature of our practices but we are nonetheless challenged to make improvements.
The challenge we are facing is how to structure our provider incentive plans to help us meet all our key aims. Traditionally, many health systems or physician practices have created wRVU based incentives plans that primarily structured to pay incentives based on productivity above a specified wRVU target. The upside of these plans is that physicians are highly motivated to stay productive. The downside is that the incentive structure invites over treating patients or pursuing aggressive treatments for patients as it provides financial rewards for the providers. However, by excluding any wRVU element in an incentive plan, we are creating an environment where potentially providers don’t have monetary incentives to increase access or efficiency.
What is the best way to blend these competing interests? How to best structure our incentive plans to balance these elements?