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| Better Care. Smarter Spending. Healthier People: Paying Providers for Value, Not Volume |
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| Accountable Care Organization Model |
Abstract
The project reported here,
sponsored by the American Medical Association (AMA), aimed to describe
the effects that alternative health care payment models (i.e., models
other than fee-for-service payment) have on physicians and physician
practices in the United States. These payment models included
- capitation,
- episode-based and bundled payment,
- shared savings,
- pay for performance, and
- retainer-based practice.
Accountable care organizations and medical homes, which are two recently expanding practice and
organizational models that frequently participate in one or more of
these alternative payment models, were also included. Project findings
are intended to help guide efforts by the AMA and other stakeholders to
make improvements to current and future alternative payment programs and
help physician practices succeed in these new payment models — i.e., to
help practices simultaneously improve patient care, preserve or enhance
physician professional satisfaction, satisfy multiple external
stakeholders, and maintain economic viability as businesses. The report
provides both findings and recommendations.
Recommendations
- To optimize the quantity and content of physician work under alternative payment models, ensure that physician practices have support and guidance.
- To improve the effectiveness of alternative payment models, address physicians' concerns about the operational details of these payment models.
- To help them succeed in alternative payment models, ensure that physician practices have data and resources for data management and analysis.
- To help physician practices respond constructively, harmonize key components of alternative payment models, especially performance measures.
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