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Physician Participation in Certain Payment Models Increases in 2016

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Earlier this month, Medscape released its “Physician Compensation Report 2016,”, and according to Carol Peckham over at the publication’s website, the report is based on information collected from “nearly 19,200 physicians in over 26 specialties,” who “disclosed not only their compensation, but also how many hours they work per week, how many minutes they spend with each patient, the most rewarding part of their job, changes to their practice resulting from healthcare reform, and more.”

As we all know, there are a variety of physician payment models out there, each with their own pros and cons. But how many physicians are actually participating in these models?

“Specialists and PCPs have similar rates of cash-only practices (6 percent and 5 percent, respectively) as well as participation in a concierge model (3 percent and 4 percent),” Peckham reports. “Thirty-seven percent of specialists participate or plan to participate this year in accountable care organizations (ACOs), which is much lower than PCP participation (45 percent). More PCPs (39 percent) also reported being in ACOs this year than in last year's report (35 percent). According to some experts, as of late 2015, questions remain about whether meeting quality metrics translates into meaningful improvement.”

The next question Medscape explored was how this participation has increased over the last five years.

The first thing they learned, Peckham writes, is that “cash-only and concierge practices are still not significant payment models,” even though both models have generated a considerable amount of press and attention in the last five years.

She continues: “In fact, as found in Medscape's Physician Compensation Reports, concierge practice has stayed at around 3 percent for the past 3 years. Cash practices saw a slight increase this year (6 percent vs 5 percent last year).”

One expert she interviewed believes this is because employment has been viewed as more of an “escape hatch” for physicians who want “to avoid the pressure of private practice,” although he added that the urgent-care and direct-pay models have both shown “continual increase.”

Not surprisingly, “[c]urrent and future participation in ACOs is still increasing, at 39 percent this year compared with 37 percent in last year’s report,” Peckham writes.

As physicians who are looking for a job, are you interested in participating in a particular kind of payment model in your next position? Which one is your preferred payment model? What are the pros and cons to it from your perspective?

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