value based physician reimbursement

Over the past several years, a gradual change has been taking place in the way doctors are paid for their services. For much of the history of modern medicine, physicians have been compensated on a fee for service basis. Granted, there was once a time when that fee might be two chickens and a nice peach cobbler. But during the 20th Century, the fee for service model became far more standardized thanks to the demands of public health care agencies and private insurers.

Today, with the emergence of value-based reimbursement embedded in legislation like the Medicare Access and CHIP Reauthorization Act (MACRA) the trend is moving toward the rewarding or penalizing of physicians based on patient satisfaction scores. Quality of service remains a key concern, of course, but there's an important difference with these new laws: patients have also become arbiters of quality.

The Importance of Patient Satisfaction

The consensus among both public and private insurance providers seems to be that satisfied patients are generally healthier. Patients who like their doctors are more likely to follow suggested exercise plans, diets, or medication regimens. These patients remain healthier over a longer period of time and healthier patients are, of course, less expensive. So, the thinking goes, physicians with satisfied patients should be paid more than physicians with dissatisfied patients.

A new program, known as the Clinician & Group Consumer Assessment of Health Providers and Systems (CG-CAHPS), tracks several metrics to determine a provider’s Patient Satisfaction Score. Over the next few years, this score will become an integral part of physician compensation models.

The Patient Satisfaction Challenge

Unfortunately, the challenges of keeping patients satisfied are growing right along with the need to do so. As new regulations for documentation and the growing use of Electronic Health Records (EHR) systems place greater demands on a physician’s time, less time is available to address patient satisfaction. In fact, many of the metrics used to evaluate patient satisfaction, like timely appointments, timely care, face-to-face communication, and waiting times are directly impacted by data capture and recording needs.

A study from the American Journal of Emergency Medicine found that 48 percent of a physician's time is spent on EHR data capture and other administrative tasks, leaving much less time for direct contact with patients. It also increases the length of appointments and the time between appointments which, in turn, decreases the number of patients that can be seen in a day. In the end, patients find themselves having to wait weeks for an appointment and sit in the waiting room for hours all for a brief, impersonal interaction with a doctor who spends more time recording information than making eye contact.

A Potential Solution

One potential solution to the patient satisfaction conundrum is the employment of a medical scribe to manage all paperwork and documentation for the physician. In many cases, they shadow the physician, acting as an assistant to handle information entry into the EHR dictated by the physician. By managing the time-consuming record-taking that providers are currently responsible for, medical scribes take a large administrative load off of physicians, who can then use their valuable time to concentrate on patient care and satisfaction. Putting physicians back in the front lines of medical care, where they belong, is likely to boost patient satisfaction because it allows them to, once again, engage with patients, communicate, and develop relationships.

Value-Based Models: Time is of the essence.

Many patient satisfaction metrics are impacted directly by how physicians spend their time. Medical scribes free the physician from the constraints of EHRs, saving valuable professional time. The time saved allows them to see more patients, stay on schedule, and, most importantly, to develop the kind of one-on-one relationship that leads to high patient satisfaction scores.

As the way doctors are paid moves from fee for service to value-based, patient satisfaction is becoming more important than ever. The use of medical scribes can be a key element in raising patient satisfaction scores and securing maximum compensation while avoiding regulatory penalties.

Of course, the most important thing is that higher patient satisfaction scores means happier, healthier patients.