Table 11.

Change in Physician Compensation Under New Model, by Payment Category With Payments for E-visits and Chronic Disease Management in 2004

Payment CategoryWith 18% Reduction in Hours Worked, $With Current Work Hours,* $
Source: Lewin Group estimates using illustrated assumptions.13
Note: numbers in parentheses indicate loss.
FTE = full-time-equivalent; FFS = fee-for-service.
* 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 2,030 patients per FTE physician.
‡ Assumes that e-visits are reimbursed at $25 per consultation up to a maximum of 25 consultations per patient per year.
§ Assumes chronic disease management is reimbursed at $15 per month for people with chronic illnesses. As in the micromodel section, the model assumes that a practice care manages only 2% of its patients. Because chronic disease management is expensive, this assumption is maintained throughout where chronic disease management is not directly reimbursed. If chronic disease management is directly reimbursed, it is assumed that 10% of patients are care managed. In addition, 2% of the population that can most benefit from intense chronic disease management is managed by 1 registered nurse for every 200 patients. For the remainder of the care-managed patients, the assumption is that each registered nurse manages 280 patients.
Current average compensation
    Mean compensation per FTE physician167,500167,500
Changes in compensation per FTE physician
    New Model within current FFS model (from microanalysis)(20,900)42,800
    With e-visit reimbursement4,6314,715
    Chronic disease management reimbursement§12,21314,834
    Total change in compensation(4,056)62,349
Total compensation under policy
    Total physician compensation163,444229,849