Switching to new payment models alone will not transform patient care, according to a joint study from the nonprofit research organization RAND Corporation and the American Medical Association.
"We found that changing the payment system probably isn't enough to ensure that patient care will improve," said Dr. Mark W. Friedberg, the study's lead author and a senior natural scientist at RAND, in a statement. "For alternative payment methods to work best, medical practices also need support and guidance. It's the support that accompanies a new payment model, plus how well the model aligns with all of a practice's other incentives, that could determine whether it succeeds."
Researchers examined alternative payment models, such as capitation, bundled payments, shared savings, pay-for-performance, retainer-based practice, accountable care organizations and patient-centered medical homes, and their effects on physicians, based on case studies of 34 practices in six markets.
The study found practices are changing to new alternative payment models and these models are encouraging team-based care management. Practices are investing in data management to help track performance and improve, but the multiplicity and administrative burden of the new models have been drawbacks.
The study also found individual physicians are slightly less optimistic about the new models than their physician leaders. This may be because the financial incentives in the new payment models have little to no effect on individual physician's aggregate income, according to the report. Respondents also said the models also have not changed clinical, face-to-face care and the nonclinical work has created some discontent among individual physicians.
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