Friday, October 23, 2009

From Time Magazine: Geisenger's Doctor Reimbursement Experiment

from Time Magazine

In the rolling hills of central Pennsylvania, the Geisinger Health System is trying something different. The 726 physicians and 257 residents and fellows who work there don't do piecework. They are paid a salary — benchmarked against the national average — plus potential bonuses based on how well their patients do under their care. ...

... A doctor's pay is not fixed in advance. Salaries are pegged so that they stay within 80% of the national average, but up to 20% of income is based on teams' achieving performance goals. If the cardiac group keeps its complication and readmission rates below a certain level, paychecks get fatter because costs decrease. Ditto for the pediatric orthopedic team, which must successfully treat kids for, say, spinal curvature without being too quick with the knife for those who don't need surgery or too slow for those who do. "We keep cash compensation flexible and incentivized," Steele says. "That takes away some of the insane piecework."

Other Ways to Reimburse Doctors:

"There's pay-for-performance: compensation depending on doctors' success in keeping costs down and getting patients well. There's episode care: a fixed price for a procedure like a heart bypass that covers everything from pre-op to surgery to full recuperation. Most broadly, there's global care, which provides access to a diverse team of caregivers who cover all of a patient's needs for a single premium over the length of a policy — essentially episode care writ large."

No comments: