FOTO Rehab Outcomes Blog

Perspectives in Alternative Payment Models

Written by Selena Horner | Feb 22, 2017 11:00:00 AM

 Yes, the one area that is concerning in the alternative payment models is the level of burden associated with data collection. Rehabilitation professionals have had more and more regulatory items to report for payment. The biggest key to reduce burden hinges on technology. There will need to be seamless integration of systems to allow processes to keep patients the main focus of care. 

The other thing I worry about when it comes to the alternative payment models is the level of complexity. Physician Quality Reporting was burdensome not only for rehabilitation professionals, but very much so for physicians. The amount of burden was probably greater than the positive impact or change in level of quality of care delivered. I'm not even sure if anything beneficial was learned or gained from that initiative. I'll keep my fingers crossed for the Merit-based alternative payment initiative.

Here's a quick view of the abstract. 

An Observational Study of Provider Perspectives on Alternative Payment Models.



Over the past decade, reimbursement in the US health care system has undergone rapid transformation. The Affordable Care Act and the Medicare Access and CHIP Reauthorization Act are some of the many changes challenging traditional modes of practice and raising concerns about practitioners' ability to adapt. Recently, physician satisfaction was proposed as an addition to the Triple Aim in acknowledgment of how the physician's attitude can affect outcomes. To understand how physicians perceive alternative payment models (APMs) and how those perceptions may vary by their organizational role, non-leader physicians (N = 31), physician leaders (N = 67), and health system leaders (N = 49) were surveyed using a mixed-methods approach. Respondents to the electronic survey, who were identified from a Jefferson College of Population Health program participant database, rated their organizations' responses to APMs and provided commentary. Analysis of the Likert scale quantitative data indicates a significant difference in ratings between the 3 groups, particularly between health system leaders and non-leader physicians. The aggregated Attitudes Toward APMs Scale indicates that health system leaders were statistically significantly more likely to rate themselves and their organizations as better prepared for APMs compared to non-leader physicians and physician leaders. Qualitative analysis of comments indicates that non-leader physicians are more negative of APMs, often expressing frustration at added administrative burdens, barriers to implementation, and inconsistent or unclear measurement requirements. These findings indicate that the negative feelings non-leader physicians and physician leaders, in particular, expressed could contribute to physician burnout and decreased professional satisfaction, and impede the effective implementation of APMs.

Popul Health Manag. 2017 Jan 18. doi: 10.1089/pop.2016.0128. [Epub ahead of print]