What You Should Know:
– Independent research reveals family physicians with 75% revenue derived from value-based payment models decrease burnout symptoms, according to a new study from Elation Health, and American Academy of Family Physicians (AAFP) Innovation Lab.
– The goal of the study, conducted by surveying 10 primary care practices of varying sizes, was to identify specific barriers and innovations required for mainstream adoption of value-based payment (VBP) models and their relationship to physician burnout.
Key findings from the study illustrate both the promise and the challenges involved with VBP models. The following themes emerged:
– Infrastructure: A significant factor in burnout is the amount of work to be done related to the resources available to efficiently do the work. The study uncovered a threshold of financial investment needed to support adequate infrastructure to enable success in VBP and reduce the associated risk of burnout. In larger practices or in practices with network affiliations, economies of scale made VBP administration more manageable. Beyond human resources, the adoption of technical solutions supported operational efficiencies, helping contain operating expenses and enabling clinical and financial success.
– Capitation Factors: Practices with capitated models, or risk-adjusted, per-person payment models, experienced less burnout than those with payment models designed around retrospective “bonus” payments. The study also replicated findings that higher capitation rates combined with the greater percent of total revenue from capitation can most effectively relieve physician burnout.
– Quality Measures: The effort required to identify, deliver, report, and get paid for a set of payer-driven quality measures is proportionally high for the majority of practices, regardless of size. The study showed that practices with fewer payer contracts had less burnout, given its link to fewer or simpler workflows to achieve success.
– Payer-Practice Contract Quality and Innovation: The most successful practices in the study benefited from innovative and savvy contract design between the practice and the health plan, sometimes involving partner health systems. Practice leaders who worked closely with payer organizations to design contracts around the power of primary care to influence downstream utilization patterns and costs of care of an attributed population realized better financial outcomes for the practice, reported a better experience of delivering care, and enjoyed the least amount of burnout.
“Value-based care holds much promise by creating supportive collaborations between patient and physician, improving quality of care, and reducing healthcare spending,” said Dr. Steven Waldren, MD, MS, chief medical informatics officer at AAFP. “In this second study with Elation Health, we found it critical to further explore the challenges family physicians face as they work to transition to value-based payment models and to understand which innovations help them break through these barriers without putting themselves at risk of burnout.”