Doctors at Medical University of South Carolina Hospital (MUSC), in Charleston, S.C., said a change in the way the facility pays physicians — using number of patients rather than money generated — will hurt quality and limit time doctors spend with patients, reported Charleston Post and Courier.
Starting in July, MUSC physicians will be paid based on the number of patients they treat rather than the amount of money generated by their department. One doctor told the Post and Courier that physicians at the hospital are "livid" about the plan.
MUSC College of Medicine Dean Raymond DuBois, who helped create the new method, said the plan is “fairer and equitable.” But MUSC President David Cole said it can create a "dysfunctional dynamic" by penalizing some doctors who are productive but treat low-income or uninsured patients.
The ongoing shift to value-based payment models presents challenges and opportunities for health systems, but there's no question it is being considered more and more. The CMS has met its goal of converting 30% of fee-for-service medicare payments to value-based models and has a goal of 50% by 2018.
Last month a group of heavy hitters in the industry issued a report pushing for more value-based models, saying they put the patients at the center of care, focus on outcomes and can reduce costs. And executives are noticing. A recent HIMSS Analytics survey found 68% of responding healthcare leaders plan to adopt new technologies to improve the use of EHRs. Another survey from Lazard found that nearly half of C-suite respondents thought the adoption of value-based models would have the most transformative impact in the industry.
But implementation without provider support is difficult.
Some MUSC departments already use relative value units (RVU) to track doctor performance. The plan that starts in July will spread RVU use across the hospital and level off departments, so physicians in less profitable areas don’t lose out.
The healthcare industry is looking for value-based payment formula solutions, but this change doesn’t specifically tackle quality. In fact, some opponents say it will just force physicians to rush patients and thus hurt quality, but MUSC says otherwise.