Table 13.

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

Payment Category	With 18% Reduction in Hours Worked, $	With Current Work Hours, $*
Current average compensation
Mean compensation per FTE physician†	167,500	167,500
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)	20,300	23,300
Diabetes care link potential bonus§
Diabetes care link bonus	0 – 11,400	0 – 13,000
Cardiac care link potential bonus II
Cardiac care link bonus	0 – 9,750	0 – 11,200
Annual performance reward¶
Performance award scored on:	0 – 20,000	0 – 20,000
Use of generic drugs
Patient satisfaction survey
HEDIS performance measures
Total change in compensation	(600) – 40,550	66,100 – 110,300
Total compensation under policy
Total net physician compensation§	166,900 – 208,050	235,500 – 277,800

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.