- Physicians at NYC Health & Hospitals (H+H), the city's municipal hospital system, have argued some of the system's quality goals are currently unrealistic, Crain's New York Business reported.
- At issue is whether the standards are in fact too high and will unfairly result in physicians losing out on tens of thousands of dollars in incentive payments.
- The physicians' contract with H+H stipulates that 5% of their payments from the system are tied to quality.
The issue highlights a potential snag in hospitals' quest toward value-based care and in placing some of the risk on physicians. In the case of H+H, those include targets on such measures as patient satisfaction and the length of time between ED treatment and hospital admission.
A source told Crain's the hospital system failed to obtain sufficient physician input, arguing, "When you identify a benchmark, it has to be achievable. You can't aim for something that no one can achieve objectively."
Dr. Andrew Brotman of NYU Langone's faculty group practice added part of the issue was
H+H aiming to achieve regional or national averages for patient satisfaction, regardless of where a facility's current baseline falls. He said NYU physicians stand to lose about $8 million if they are unable to reach any of the benchmarks, which translates to $20,000 in unearned incentives per physician. He suggested said some of the measures are attainable now while others may be attainable in the future.
Sources told Crain's the issue has brought a rift between the system's physicians and its new chief transformation officer, Dr. Ross Wilson.
H+H, meanwhile, responded with a statement that, "We have set high, yet realistic performance improvement goals as part of our physician affiliate contracts and will continue to discuss these new expectations with our the affiliate organization partners."