Payment Model Shift From Fee-For-Service to Pay-For-Performance

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Table of Contents

Introduction
Discussion
Conclusion
Reference

Introduction

Under the fee-for-service (FFS) payment model, medical professionals receive compensation for the care they provide to their patients based on their time and effort. Since payment focus on the number of services rather than the quality of those services, this creates an incentive for more substandard treatments to be rendered, decreasing overall treatment quality. Due to this, the payment model results in unnecessary over-provisioning, inefficiency, and unregulated increases in medical costs. Consequently, there has been an increasing demand for a transition towards the pay-for-performance payment model, which places a greater emphasis not on the quantity of treatment provided but on the quality of the services provided to the patient. This article summarizes the factors identified by Ogundeji and colleagues (2021) as influencing specialist physician preferences for fee-for-service and salary-based payment models.

Discussion

Every companys primary objective should be maximizing its profits while simultaneously reducing operating expenses. Therefore, the desires of physicians for autonomy and independence, in addition to their professional interests, are factors that play a role in determining their preferred payment models (Ogundeji et al., 2021). Since they ensure that doctors are paid consistently, fee-for-service payment models are an absolute requirement whenever there is a pressing need for additional funding. According to Ogundeji et al. (2021), physicians who favor a pay-for-performance model are more concerned about giving their patients high-quality care that improves the outcomes of their conditions. It is due to this reason that more focus should be on this model since it ensures better services are advanced to patients.

Those involved in delivering healthcare services have the same incentive as other business owners to maximize profits as they seek to reduce expenses wherever possible. Ogundeji and colleagues (2021) further reveal that being an FFS physician means that the physician has special interests in the health facilities and is more likely to be the practice owner, which necessitates having control and autonomy over the practice. According to Ogundeji et al, (2021) findings, this was the primary reason why physicians favored the FFS payment model in the first place. This autonomy includes the freedom and decision-making authority to make staffing and other business-related decisions. Their research on factors that influence specialist physician preferences for fee-for-service and salary-based payment models shows that the perspectives of male and female medical professionals are distinct. Compared to their concerns regarding other aspects of their lives, male FFS physicians with advanced careers were most concerned about protecting their autonomy.

If a payment model is to be successful, it should be flexible enough to accommodate changing circumstances and provide doctors with a reasonable work-life balance. According to research by Ogundi et al. (2021), female doctors in their early to mid-career years are interested in compensation plans that give them the freedom to strike a good work-life balance. The doctors indicated that the freedom to determine their work schedules (in the case of FFS doctors) or their salaries (in the case of salaried doctors) was the deciding factor in selecting their preferred payment method. Many respondents valued time with their families, especially their young children, and appreciated compensation plans that allowed them to do so. These physicians felt they could be more involved in their kids lives because of the money they were making and the flexibility they enjoyed while practicing their profession.

Alternative payment models are gaining popularity among medical personnel who are just beginning their careers in the medical field due to the numerous benefits that these models offer. The findings on the factors influencing specialist physician preferences for fee-for-service and salary-based payment models suggest that most specialists, particularly younger physicians, would rather accept alternative payment methods. The study found that specialist doctors interested in furthering their education and conducting research studies preferred the salary-based model over FSS. It was something that came as a surprise to the researchers. Some specialists liked the salary-based model better because it allowed them to spend more time with patients and on research while allowing them to keep the same amount of money coming in each month. The fact that salary-based practices offer more opportunities for professional development and exploration is one of the primary reasons why specialists and doctors interested in academia tend to favor those practices. Based on these findings, alternative payment models can gain widespread adoption provided that they are adapted to the needs of specialized researchers and clinicians and provide appropriate incentives for them, all the while taking into account the interests of individuals who are just entering the field.

Conclusion

In conclusion, physicians advocating for a system of compensation based on patient outcomes place a premium on providing that care to guarantee better patient care. The payment models focus should be shifting away from the FFS payment model. Autonomy was the most pressing issue for male FFS physicians with advanced training. As part of this independent, payment will have the leeway and authority to make choices about the organizations personnel and other operational aspects. This model warrants additional attention because it guarantees improved patient care. The findings on factors influencing specialist physician preferences for fee-for-service and salary-based payment models suggest that most specialists are open to alternative payment models in place of traditional salary arrangements.

Reference

Ogundeji, Y. K., Quinn, A., Lunney, M., Chong, C., Chew, D., Danso, G., Duggan, S., Edwards, A., Hopkin, G., Senior, P., Sumner, G., Williams, J., & Manns, B. (2021). Factors that influence specialist physician preferences for fee-for-service and salary-based payment models: A qualitative study. Health Policy, 125(4), 442-449.

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Payment Model Shift From Fee-For-Service to Pay-For-Performance

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