The median revenue amount from value-based contracts across all practices was $30,922 per provider in 2021.
Even with the healthcare industry trending towards more value-based care, the transition away from fee-for-service is happening at a slow rate.
Medical revenue continues to predominantly consist of fee-for-service payments, with value-based care making up just a small slice, according to a report by the Medical Group Management Association (MGMA).
The survey found that revenue from value-based contracts accounted for 6.74% of revenue in primary care specialities, 5.54% in surgical specialities, and 14.74% in nonsurgical specialities. Across all practices, the median revenue amount from value-based contracts was $30,922 per full time equivalent provider.
MGMA examined 2021 data from more than 2,300 organizations from a variety of specialties and practice types to gauge the shift to value-based reimbursement.
The research also revealed that the share of physician compensation tied to quality performance has changed during the pandemic. More than a third (35%) of medical groups report they have increased the share of compensation tied to quality in the past two years, while 62% said they have the same share compared to 2019. Only 2% of respondents said they have decreased the percentage of compensation tied to quality.
The workforce shortage has had an affect on appointments, the survey stated, with appointment availability for new patients increasing by two days, from 6.1 days in 2020 to 8.1 days in 2021.
While no-show rates held steady, appointment cancelations also increased across nonsurgical and surgical specialties, jumping from 8.3% in 2020 to 17.7% in 2021, and from 7.0% to 8.4%, respectively. Primary care experienced a slight decline in cancelations from 8.3% to 8.0%.
Practices reported that it took longer to post charges in 2021 for third-party payment from the time a patient is seen. Primary care saw a dip in charge-positing lag time from 5.2 days in 2020 to five days in 2021, but nonsurgical and surgical specialties jumped significantly, from 6.8 to 11.6, and from 6.8 to 10.4, respectively.
The number of claims denied on first submission also rose in 2021, across all specialty types. Primary care saw an increase from 4% to 8%, nonsurgical went up from 3% to 8.14%, and surgical leapt from 4.16% to 8.14%.
However, percent of copayments collected at the time of service decreased across the board.
With the stress that's placed on the dwindling number of staff, optimizing administrative operations is key to alleviating the challenges practices are facing today.
"The medical workforce is grappling with burnout, staffing declines, decades-high inflation, operational challenges and a dynamic reimbursement environment that affects providers across the board," Halee Fischer-Wright, president and chief executive officer of MGMA, said in a statement.
"This report reveals how addressing scheduling errors and billing denials could help relieve the financial burden on health groups, moving them toward value-based care that promotes the welfare of physicians, staff, and patients."
Jay Asser is the contributing editor for strategy at HealthLeaders.
KEY TAKEAWAYS
Revenue from value-based contracts accounted for 6.74% of revenue in primary care specialities, 5.54% in surgical specialities, and 14.74% in nonsurgical specialities.
The workforce shortage has impacted appointments as appointment availability for new patients and appointment cancelations exerpeinced increases.
Practices said it took longer to post charges for third-party payment from the time a patient is seen, while the number of claims denied on first submission went up.