Study: Doctors need help adjusting to value-based payment environments

Assistance could come from payers, more gentle regulations
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Alternative and value-based payments may be the wave of the future in healthcare, but providers are unprepared to actually accept them, according to a new study.

That's the conclusion of researchers at the Rand Corp., which conducted the study on behalf of the American Medical Association (AMA). Researchers examined 34 different medical groups across the United States that were engaged in alternate payment models. The models studied include episode-based and bundled payments, shared savings, pay-for-performance, capitation and retainer-based practices, accountable care organizations and medical homes.

Such payment models have been promoted by the Obama administration as a way to cut healthcare spending and control costs in the long term.

Altogether, the different payment model systems had a neutral to positive impact on the physician practices, according to the study, and none actually experienced any financial hardship, the AMA said in a study announcement.

However, the study concluded that payers should provide assistance to practices in order to better manage the patient information they control and help them create performance guidelines and models that are easier to understand. An easing of government regulations would also help practices better focus on improving patient care.

"For many doctors and many physician practices, the desire to be paid a different way is there, but actually doing this is quite difficult," Mark Friedberg, M.D., an internist at Rand and the study's lead author, told Forbes magazine. "To do well with population health metrics, (doctors) had to develop a data infrastructure that they didn't have. Those kinds of changes require major investments."

The study did not delve into other issues created by alternative payment models, such as whether their cost-curbing properties deprive providers of the capital to investment in new technologies.

To learn more:
- read the study
- check out the AMA announcement
- here's the Forbes article

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