Healthcare

 

How should physicians be reimbursed for the care they provide? This highly-debated topic can be answered in a variety of ways, and no one answer fits all practice settings. Let’s take a deeper dive into this topic and investigate the financial impact of using productivity, quality, and financial measures to create a reimbursement structure.

A large family practice group is meeting to discuss restructuring their payment model. The practice has four physicians, each with a different patient population:

  • Dr. Andrews: large pediatric patient base, full-spectrum obstetrics/gynecology
  • Dr. Brown: geriatrics, disease management
  • Dr. Cascara: general family practice, cosmetic laser procedures
  • Dr. Dole: general family practice, low-risk obstetrics/gynecology

As the clinic manager, you play an active role in the daily implementation of managing the patient populations and ensuring accurate reimbursement is processed. The practice manager, Jane, has asked to meet with you to hear your thoughts on restructuring the physician payment model.

  • Compare and contrast the impact of using productivity measures among the four physicians. Briefly explaining which productivity measures could benefit each physician, and why.
  • Discuss how quality measures could be used to determine reimbursement. Which physicians would this currently benefit? Which might struggle in this area, and why? (Note: you will need to assume fictional information to form this response).

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