5 Points on Orthopedic Surgeon Preferences for New Payment Models Featured

Written by  Laura Dyrda | Thursday, 21 February 2013 15:37
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Here are five points on orthopedic surgeon preferences for new payment models.
1. Value-based programs. According to the LocumTenens.com Annual Compensation and Employment Survey completed in the spring of 2012, orthopedic surgeons have a moderate familiarity and comfort level with value-based payment programs. On a scale of one to five, with one being "very unfamiliar" and five being "very familiar," orthopedic surgeons ranked themselves as a "three" when it comes to value-based programs. On average, orthopedic surgeon respondents would expect a 32 percent bonus to participate in accountable or value-based care programs, but would only agree to risk about 7 percent of their income in exchange for a potential bonus, according to the report.

2. Bundled payments.
Orthopedic surgeons are more comfortable with bundled payments than shared savings arrangements and value-based programs, according to the LocumTenens.com report. They ranked around "3.5" on a five-point familiarity scale and ranked around "2.5" on their average comfort level for bundled payments. Orthopedic surgeons reported having slightly higher comfort with bundled payments that have risk protection than programs without risk protection, and only 38 percent of orthopedic surgeons reported bundled payments as their preferred payment model.

3. Pay-for-performance.
The most popular payment model for orthopedic surgeons was pay-for-performance, which 46 percent said they would prefer over bundled payments and shared savings arrangements in the LocumTenens.com report. Orthopedic surgeons were most comfortable with the pay-for-performance model — ranking themselves at nearly four on a five-point familiarity scale and a three on comfort.

4. Shared savings arrangements.
Orthopedics surgeons were least familiar and least comfortable with shared savings programs. They ranked themselves as a 2.25 on the five-point familiarity scale and slightly over two on the five-point comfort level scale, according to the LocumTenens.com report. However, 16 percent said shared savings was their preferred payment model, which was higher than bundled payment programs without risk protection.

5. Accountable care organizations.
The Medscape Orthopedist and Orthopedic Surgeon Compensation Report conducted in early 2012 showed that only 2 percent of orthopedic surgeons were currently participating in accountable care organizations, while another 5 percent expected to join one over the next year. Around 64 percent felt ACOs would cause a decline in income, with 38 percent feeling it would be a large decline. In the LocumTenens.com survey, orthopedic surgeons said their preferred payor was Medicare for accountable care organizations, with 24 percent. Another 21 percent said they would prefer commercial insurers while 8 percent said they would prefer Medicaid. The remaining 61 percent they would prefer not to participate in an accountable care or value-based care arrangement.

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