Browse by Topic
More than 40,000 members value HFMA's thought leadership and practical strategies. HFMA is where you need to be.
Get acquainted with the
healthcare finance industry's leading professional association. Find out why our
members rely on HFMA as their go-to source for insight and
Members have many
options for helping them advance their careers. Conferences, seminars,
eLearning, certification, and more -- our education and events will keep you
Connect the dots on today's big issues, explore collaborations, get career-boosting tips, and network with colleagues nationwide at the leading finance conference. Save $100 off the full conference rate when you register by May 8.
Real-time presentations with nationally recognized experts, networking opportunities, and industry solutions—no travel required!
Learn about timely healthcare finance topics and earn CPEs. Most live webinars are free for HFMA members and $99 for non-members. View the latest schedule.
If you're a subscriber to any of our three newsletters, you have access to online education. Learn more or subscribe.
Get the perspectives of leading healthcare finance professionals on today's hottest issues.
Information about leading vendors helps your buying decisions.
Forum members can network during live webinars or access a library of past webinars on topics such as bundled payment, charity care, and ICD-10.
An ever-expanding collection of spreadsheets, policies, job
descriptions, checklists, and more that you can adopt and adapt.
Forum members can submit vexing questions to a panel of experts
using our Ask the Expert service.
Your source for employment solutions.
Find new employment opportunities or
reach out to qualified candidates.
Distinguish yourself as a
leader among your peers and advance your career by earning certification in our
healthcare finance programs.
Get an objective third-party evaluation of products and services used in the healthcare finance workplace.
MAP App is a web-based application that helps organizations improve revenue cycle performance based on industry-standard metrics called MAP Keys.
Find suppliers and products in this comprehensive vendor directory for healthcare finance professionals.
Guidance for understanding and communicating about the price of health care.
Transformation toward value-based healthcare is reshaping the delivery of care, patient expectations, and payment structures.
Improve your revenue cycle performance through standard metrics, peer comparison, and successful practices.
New payment models offer an unprecedented opportunity to reward physicians for their efforts to improve quality and cost performance. That’s the good news. But when you accept the role of distributing funds to physicians, you had better set it up right.
The funds used to reward physicians often come in the form of incentives or shared savings from payers. Ideally, you will be able to decide how to distribute them to physicians to reward performance.
Here are a few tips for setting up an incentive distribution model.
Agree on key principles. An important characteristic of a successful incentive distribution model is that it feels fair and appropriate to physicians. One way to cultivate this feeling in physicians is to establish principles jointly with physician leadership, and then design the incentive distribution model according to those principles. Possible principles include:
Identify metrics. Metrics should be selected to support initiatives that will lead to success in the payer contract. Ideally, those metrics will already be important to your hospital and physicians and will link to your goals (e.g., core measures for hospitals and Medicare PQRS measures for physicians).
Organizations pursuing an accountable care organization (ACO) strategy should consider that initial measures typically center on primary care physicians. Initial measures for organizations pursuing bundled payment models tend to be more specialty-focused. Metrics can also be used to create incentives for other behaviors you are seeking, such as attendance at certain staff meetings or educational programs.
Assuming that you are successful and that there are incentive funds to be distributed, these metrics can become the building blocks for the physician incentive pool distribution model.
Define the incentive distribution methodology. Allocating points to each metric creates a simple distribution methodology, and one that is easily explained to physicians. For example, a basic model could have 10 metrics, and each metric could have a value of one point.
At the end of the measurement period, you divide the total points earned by all physicians into the total dollars in the incentive pool, thereby establishing a value per point. Physicians then receive an incentive equal to their points earned, multiplied by the value per point.
If overall performance results in more dollars in the total incentive pool, the value of each point will go up. Over time, the distribution of points can be adjusted to focus on specific initiatives. For example, if an organization’s goal is to reduce readmissions for congestive heart failure, then the point model can be adjusted to either include more CHF-related measures or to reallocate the points so that CHF-related measures are more heavily weighted.
Other Considerations. In some ways, principles, metrics, and methodology are the easy things. There are many other considerations that make these efforts “interesting". Securing physician buy-in is likely to be challenging; the logistics of data collection will surely be more difficult than identifying the measures. Incentives will need to be designed to drive both individual and group practice performance, and to affect both independent and hospital-employed physicians appropriately. Lastly, all of this has to be done in a way that complies with regulatory requirements.
John M. Harris is a principal, DGA Partners, Bala Cynwyd, Pa., and a member of HFMA’s Metropolitan Philadelphia Chapter.
Carole J. Graham, RN, is a manager, DGA Partners, Bala Cynwyd, Pa.
Publication Date: Thursday, June 06, 2013
Tom Myers, chief strategy officer, The SSI Group, discusses the shifting payment environment and how it affects providers' patient access and claims management processes.
Jeff Chester, senior vice president and chief revenue officer at Availity, shares his thoughts on "Revenue Cycle 2.0" and how to best meet its challenges.
Mitch Morris, vice chair and global leader, healthcare, Deloitte, and Michael O'Rourke, senior vice president and chief information officer, Catholic Health Initiatives (CHI), share perspectives on the need for transformational IT in health care today.
Brian Kueppers, founder and CEO, Apex, discusses the importance of a robust patient payment strategy in boosting organization revenue and enhancing patient satisfaction.
Brian Grazzini, CFO, HealthPort, describes the importance of efficient and compliant information exchange and audit management in helping HIM staff spend less time on paperwork and more on mission-critical projects.
Cindy Matthews, executive vice president, Community Hospital Corporation, discusses how rural and community hospitals can use collaborative partnering to position for success through tough market conditions.
Rick Heise, senior vice president, revenue cycle, at Cerner Corporation, discusses the importance of integrating clinical and financial data to excel in health care’s changing payment environment.
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
HFMA's print, email, online, and mobile opportunities provide you maximum reach and impact. We will work with you to build a plan that meets your needs. Contact a sales rep.
HFMA offers online, email, and print opportunities to help you recruit the most talented healthcare finance professionals. Place your classified ads today.
Drive down costs while improving quality in a reform environment.
Stay informed about new directions in healthcare finance. Share tools and strategies for improving performance. Be an active participant in your profession. Together, we’ll reshape the business and practice of healthcare. Join us.
©2015 Copyright Healthcare Financial Management Association
HFMA.org is best viewed using IE9 or the latest versions of Chrome, Firefox, and Safari.
Join HFMA today and enjoy: