Market Drivers for Value-Based Primary Care Physician Compensation Models

July 7, 2023

As featured by the American Association of Provider Compensation Professionals (AAPCP)


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To support the achievement of the Triple Aim goals, The Centers for Medicare and Medicaid Services (CMS) set forth a plan to shift Medicare’s reimbursement methodology from a volume-based system to a value-based system. Given evolving CMS reimbursement methodologies and innovation programs, along with the growing adoption of Medicare Advantage plans and local market opportunities for commercial payer APMs, healthcare organizations are increasingly implementing provider compensation plans that support the behaviors needed to perform well under value-based reimbursement methodologies. As such, incorporating team-based methodologies and the consideration of panel management is a growing trend.

In this article, published by the American Association of Provider Compensation Professionals (AAPCP), SullivanCotter highlights a case study that includes:

  • Defining the Team in Team-Based Care
  • Anticipating the conversion from fee-for-service to risk-based primary care services in a large community-based health care system with a significant commercial payer relationship
  • Evolving their primary care delivery model from a physician-centric approach to a team-based approach to achieve organizational value-based care delivery goals
  • Assessing the regulatory requirements and Fair Market Value (FMV) implications for these compensation arrangements

Originally published by the American Association of Provider Compensation Professionals

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