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