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ACO incentives not enough to inspire change in compensation policies

Primary care physicians that worked in accountable care organization practices received higher compensation rates from quality, but not from salary or productivity, where rates were comparable with nonaccountable care organization practices, according to recently published data.

“… The incentives for (accountable care organizations) may not be sufficiently strong to encourage practices to rapidly and substantively change their physician compensation policies to create incentives for better patient experience, improved population health, and lower per capita costs,” the researchers wrote.

The researchers assessed disparities in compensation of primary care physicians between practices in accountable care organizations (ACO) and practices that have varied assumed risk for primary care costs.

Among physicians in ACO practices, results demonstrated that 49% of compensation was received from salary, 46.1% from productivity, 3.4% from quality and 1.5% from other factors. These findings were comparable to physicians in non-ACO practices with low risk for primary care costs.

Physicians in non-ACO practices with substantial risk for primary care costs were found to receive 66.6% of compensation from salary, 32.2% from productivity, 0.8% from quality and 0.4% from other factors, according to study results.

A significant association was found between participation in ACOs and physician compensation for quality. The researchers noted that no such association was seen between ACO participation and compensation from salary.

Substantial risk for primary care costs was significantly associated with higher compensation from salary (P < .05), according to the study.

“The ACO experiment is new, and it may take some time and experimentation for practices to shift toward the most effective compensation policies for their physicians. Ongoing evaluations will assess whether the ACO programs are effective in achieving the triple aim. Nonetheless, if incentives are not aligned between practices and physicians, the ACO programs may have limited effects on costs and quality in the short-term,” the researchers concluded. – by Casey Hower

Disclosures: The researchers report no relevant financial disclosures.