Take value-based care beyond just financial rewards


For value-based payment programs to succeed, insurers must provide incentives for providers that involve more than financial rewards. That's because a wide range of factors, including intrinsic motivation and medical professionalism, influence provider behavior, according to a new blog post from the Commonwealth Fund.

Doctors often have innate interests in or enjoyment of certain activities that can serve as strong incentives to perform their best. Plus, their sense of professionalism and their desire to help people can motivate them to provide the best care possible.

Organizational influences are another factor insurers can use to encourage provider participation in value-based payment programs. Each organization's culture, management style and structure, including how appointments are scheduled and what resources are available, can help compel providers to deliver high-quality care, notes the Commonwealth Fund.

Lastly, insurers can make use of policies to affect providers' decision-making. Whether federal, state or local, policies drive what services are paid for and what type of service each medical professional can provide.

Based on these influences, the Commonwealth Fund suggests that insurers use innovative approaches to boost provider participation in value-based programs, including:

  • Providing financial incentives upfront since research shows people generally pay more attention to avoid financial loss than achieve more money. For example, the Massachusetts General Physicians Organization has found success in delivering upfront financial rewards to providers, though they can take back some money if doctors don't meet their performance standards.
  • Leveraging providers' innate desire to do a better job. Research has indicated motivators unrelated to money, such as peer comparisons or rankings, can strengthen people's desire to perform well. That's largely why quality report cards for cardiac surgeons in Pennsylvania boosted performance four times more than financial incentives.

Another successful tactic insurers can take to obtain provider buy-in for value-based care is to improve their interactions with doctors. That includes enhancing collaborations by thinking differently and not blaming providers for problems in the process, FierceHealthPayer previously reported.

To learn more:
- here's the Commonwealth Fund blog post

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