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AMA Physician Benchmark Reports on Compensation Methods and on Prevalence of New Models of Care

Two 2014 Physician Practice Benchmark Survey reports have been released by the American Medical Association within the past few months. The first looks at compensation models used to pay physicians, and the second provides data on the prevalence of physician participation in accountable care organizations and medical homes and the use of alternative payment methods [capitation, pay-for-performance, bundled payments, or shared savings].

Here are some of the key findings from the reports:

  • For many physicians, compensation was a blend of different methods. Half of compensation for non-solo physicians came from salary, another third was productivity-based, 12% was based on practice financial performance, and 4% came from bonuses. The proportions varied when analyzed by type of practice and its ownership.
  • Fee-for-service is still the dominant payment method for physicians, although 59% of physicians said their practice received some revenue from an alternative payment method. An average 72% of practice revenue came from fee-for-service. Unsurprisingly, practices participating in a medical home or ACO received a larger proportion of their revenue from alternative payment methods.
  • In 2014, 24% of physicians worked in practices that were part of a medical home, and 29% reported working in a practice that was part of an ACO. Participation rates were higher in multi-specialty practices and lower in solo practices. Hospital-owned practices also had higher medical home and ACO participation rates.
  • In single specialty practices, participation in a medical home was lowest for surgery and its subspecialties and highest for family practice and pediatrics. However, ACO participation was highest for general surgery and family practice but low for pediatrics

Sources:

Kane CK. Payment and delivery in 2014: the prevalence of new models reported by physicians. American Medical Association Policy Research Perspectives, Dec. 2015. http://www.ama-assn.org/ama/pub/advocacy/health-policy/policy-research.page – expand Medical Practice section to select report [free web site registration and login required to view/download]

Kane CK. How are physicians paid? A detailed look at the methods used to compensate physicians in different practice types and specialties. American Medical Association Policy Research Perspectives, Aug. 2015. http://www.ama-assn.org/ama/pub/advocacy/health-policy/policy-research.page – expand Medical Practice section to select report [free web site registration and login required to view/download]

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

2014 Survey of America’s Physicians: Practice Patterns and Perspectives

The Physicians Foundation is out with its latest biennial survey of physicians in the country, looking at work satisfaction, practice patterns, and other attitudes of over 20,000 survey participants. Key questions addressed in the survey include these:

  • Are they seeing more or fewer patients?
  • Do they continue to accept Medicare and Medicaid as a form of payment?
  • How do they grade the Affordable Care Act?
  • How many are part of an ACO?
  • What effect have electronic medical records had on their practice?
  • Are they independent practice owners or employees?
  • Do they plan to retire, work part-time, practice concierge medicine, seek hospital employment, or pursue some other option?

And here are some of the answers from physicians:

  • 38% do not see Medicaid patients or limit the number of Medicaid patients seen.
  • 46%  give the Affordable Care Act a failing grade.
  • 26% participate in an ACO, but only 13% think ACOs will improve quality or lower costs.
  • 85% have adopted electronic medical record,s but 46% say they detract from their efficiency.
  • 53% describe themselves as employees, up from 44% in 2012.
  • 44% plan to take steps that could impact the physician supply and patient access, such as retiring, closing their practices to new patients, cutting back on the number of patients seen, or seeking a non-clinical job.

Source: Merritt Hawkins. 2014 survey of America’s physicians: practice patterns & perspectives. Physicians Foundation, Sept. 2014. http://www.physiciansfoundation.org/uploads/default/2014_Physicians_Foundation_Biennial_Physician_Survey_Report.pdf

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org