Table 13.

Change in Compensation per Physician Under New Model With Mixed Reimbursement Model

Payment CategoryWith 18% Reduction in Hours Worked, $With Current Work Hours, $*
Source: Lewin Group estimates using illustrated assumptions.13
FTE = full-time-equivalent; HEDIS = Health Plan Employer Data and Information Set.
Note: numbers in parentheses indicate loss.
*Assumes physicians use savings in time worked to increase patient volume to maintain total hours worked per week.
† Assumes all patients are enrolled in participating health plans. Assumes average panel of about 2,030 patients per FTE physician.
‡ Annual fee based upon the net cost of implementing the New Model (estimated net cost of $18,123 at current patient volume, rounded to $10 per patient).
§ Bonus of up to $80 per diabetes patient for high scores in providing diabetes care. Assumes 7% of patients are diabetic.
II Bonus of up to $160 per cardiac patient for high scores in providing cardiac care. Assumes 3% of patients have cardiac conditions.
¶ Annual bonus amount based upon performance indicators up to $20,000 per physician.
Current average compensation
    Mean compensation per FTE physician167,500167,500
Changes in physician compensation per physician
    New Model under current fee-for-service model (taken from microanalysis)(20,900)42,800
Annual New Model fee per patient
    New Model fee per patient ($10 per patient per year)20,30023,300
Diabetes care link potential bonus§
    Diabetes care link bonus0 – 11,4000 – 13,000
Cardiac care link potential bonus II
    Cardiac care link bonus0 – 9,7500 – 11,200
Annual performance reward
    Performance award scored on:0 – 20,0000 – 20,000
    Use of generic drugs
    Patient satisfaction survey
    HEDIS performance measures
    Total change in compensation(600) – 40,55066,100 – 110,300
Total compensation under policy
    Total net physician compensation§166,900 – 208,050235,500 – 277,800