Thursday, June 20, 2013

MGMA: Physician Compensation Increasingly Based on Quality Measures

MGMA: Physician Compensation Increasingly Based on Quality Measures

MGMA: Physician Compensation Increasingly Based on Quality Measures

John Commins, for Health Leaders Media , June 14, 2013

Primary care physicians have 3% of their total compensation based on quality measures, but doctors will increasingly be tied to these metrics as reimbursement aligns more closely with quality and cost measures, Medical Group Management Association data suggests.
Quality measures are emerging as components in physicians' compensation, a trend is expected to grow as value-based reimbursements gradually supplant fee-for-service, volume-based models, a new survey from the Medical Group Management Association shows.
The Physician Compensation and Production Survey: 2013 Report Based on 2012 Data examined data on more than 60,100 physicians, and found that primary care physicians and specialists reported that 3% and 2%, respectively, of their total compensation was based on quality measures.
Although the percentages are small, MGMA's Todd Evenson says physician compensation will increasingly be tied to these metrics as reimbursement aligns more closely with quality and cost measures.

"Really what we are seeing is the very front end for many organizations as they start to address under the Affordable Care Act and the commercial environment value based reimbursement. Ultimately those components of quality and satisfaction will become an ever-emerging component of reimbursement," says Evenson, MGMA's director of data solutions."
Actually, Evenson says the survey is low-balling the extent of quality measures in compensation packages for some healthcare organizations.
"Clearly there are some groups that are much more dynamic in the way they have been able to apply that. It's not uncommon in the industry and in many of the large organizations or health systems for that number to be somewhat higher. I have talked to many colleagues in the industry and figures anywhere from 10% to 30% aren't that uncommon for those larger institutions," Evenson says.
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"As we look toward large healthcare institutions, the likelihood that they have decoupled compensation from collections is very high. And as a function of that in order to promote the behaviors around quality and satisfaction that they would like to see they want to incentivize their physicians in the appropriate ways to compensate them for those behaviors or activities. But overall, when we are looking at smaller organizations or medium-sized organizations then it is much more likely that there is that direct linkage."
Evenson says it's not necessarily a bad idea for some healthcare organizations to wait and watch before launching a quality component in their compensation packages.

Doc Pay

Physician/Specialists Compensation, 2008-2012 (PDF)
"You don't want to be on the cutting edge. You want to be just behind the cutting edge as it relates to how you change your compensation strategies," he says. "It wouldn't be very effective if you were being paid 90% fee-for-service and paid 50% on quality to your teams of providers. The math wouldn't work in your favor."
Physician Compensation
The report also reaffirmed that median compensation for physicians fluctuated by specialty. Primary care physicians reported $216,462 in median compensation in 2012, and specialists reported $388,199 in median compensation. Evenson says the considerable gap in compensation could prove difficult to overcome, even with a concerted push to get more medical school students to take up primary care.
"The last data I had a chance to look at as I looked towards family practitioners just coming out of residency was something like 40% had over $200,000 in debt. And when we see that coupled with the median compensation for a family practitioner this year was right around that $205,000, it ends up being where there is definitely a constraint that is worth noting," Evenson says.
"We and others in the health industry understand the importance of this. The demand for primary care physicians is going to continue to increase but we have seen that kind of differential between primary care and specialty care compensation. We've even seen a number of advocacy efforts from a number of organizations (to improve primary care compensation) and that continues to evolve, but unfortunately it has remained at a static pace as a ratio of one related to the other. We did see some narrowing of that gap over the last few years, but I have seen that stagnate."
Evenson says the report verifies that healthcare organizations are moving toward an increasing reliance on physicians' assistants and nurse practitioners to make up for the shortage of primary care physicians. As a result, these highly specialized nurses are enjoying significant compensation hikes.
Over the past five years nurse practitioners' compensation has increased, on average about 13.4%, to the median of $92,717 in 2012. For physicians' assistances in the surgical suite that compensation increased by 9.6% over five years to a median of $112,689. For physicians' assistants in the primary care setting the compensation increased 10.4%, with a media of $96,834 in 2012, MGMA reported.
"When we look at their compensation this really underscores how the environment and the healthcare system is leveraging providers to the maximum of their license," Evenson says. "It shows how teams and organizations are dealing with that primary care shortage. They are looking towards the nurse practitioner and their role in the organization. Even if you're in a gastroenterology practice they are leaving the scope work to the physicians and the follow up visits to the practitioners. They are leveraging them to try to meet that demand."

John Commins is a senior editor with HealthLeaders Media. 

Monday, May 27, 2013

2011-2020: United Nations Decade on Biodiversity

United Nations Decade on Biodiversity

The United Nations General Assembly declared 2011-2020 the United Nations Decade on Biodiversity (Resolution 65/161). The UN Decade on Biodiversity serves to support and promote implementation of the objectives of the Strategic Plan for Biodiversity and the Aichi Biodiversity Targets, with the goal of significantly reducing biodiversity loss.

Tuesday, March 12, 2013

Maynard's Texas Vegan Buffet

Maynard's Texas Vegan Buffet

Let's have a contest (no cash prizes - just "posted popularity") to
ENVISION a full vegan restaurant concept
(start-to-finish imagination): 

I'll start!

Maynard's Texas Vegan Buffet

Get all you can and can all you get


Dietitian-developed vegan buffet complete with calorie counts, sign up for birthday parties and anniversaries, celebrations of going vegan, etc.  Everyone dressed in colorful uniforms made of vegetable-patterned or fruit-patterned cloth, different vegetables celebrated each day, with free recipes tweeted out (or in RSS feeds) to those who sign up online or in the vegan buffet centers; big parties for vegetarian days, such as GAMO (Great American Meatout), World Vegetarian Day, National Heart Month, International Vegan Day, Gandhi's birthday, Feast Day of St. Francis, etc.

Concept: Overeating - if you dare, but we strongly advise against it, for the following reasons: 1, 2, 3, 4.  We CAN make eating right amounts of vegan food VERY satisfying by integrating culinary arts with dietetic and nutritional science and skill.  We educate and nurture our clients - in person and electronically.  Value-Added venue that is affordable (on both sides) and sustainable.

Thursday, October 04, 2012

How to DO Animal Rights! Free Online eBOOK

How To Do Animal Rights
Your completely freeonline-book to action animal rights.

How to Do Animal Rights - buy the book
Buy the book version ofHow to Do Animal Rights.

...or buy the shorter eBook version at Amazon. For details see the book page.
Amazon ebook of How to Do Animal Rights.


You may copy the online text of How to Do Animal Rights for your non-profit personal use to promote animal rights.

Please read & comment.

Selected Links

Animal Welfare Online
Valuable practical info for AR campaigning, from WSPA.

  • Animals Asia Foundation
    Helping bears and literally millions of dogs and cats horrendously treated in Asia.
  • Online writings of Peter Singer

  • Humane Research Council
    Researches and analyses data to help animal advocates make their case.
  • BBC Animal Ethics
    A nicely concise introduction to animal ethics.
  • International Aid for Korean Animals
    Millions of cats & dogs cruelly treated & eaten in Korea & what you can do about it.
  • Animal Ethics Dilemma
    Explore your personal animal morality.
  • The Animal Activists Handbook
  • Animal Activists HandbookPractical action on alleviating animal suffering. Written by PETA activists Matt Ball & Bruce Friedrich. 2009. 128 pages.

  • Dawn Watch
    Tracking animals in the media & where you can make your voice heard.
  • Protecting Animals in Democracy
  • Protecting Animals in DemocracyAchieving political representation for animals through politics.

  • Animal Liberation Front
    Many good ideas for animal activism.
  • Voice for Ethical Research at Oxford
    Oxford University members who oppose animal research & aim to further ethical alternatives.
  • Striking at the Roots
  • Striking at the RootsRead about doing animal rights in this paperback by Mark Hawthorne.

  • Animal Rights Concerns
    About vegetarian diet and vegan lifestyle to steer society away from animal use.
  • World Animal Day
  • World Animal Day

  • Abolitionist Online
    Australian web site for animal rights.
  • Oxford Centre for Animal Ethics
    Academics pioneering the animal ethics debate.
  • UK Animal Rights
    Web links providing animal rights information, news and resources.

  • Introducing myself

    Search this web site:

    How to Do Animal Rights

    Chapter 1

    How to Do Animal Rights

    Chapter 2
    Philosophy: Key Topics

    How to Do Animal Rights

    Chapter 3
    Campaigning: Methods for Animal Rights 

    Animal rights grows.

    How to Do Animal Rights

    Chapter 4
    Activities for Animal Rights

    Animal rights empathy.

    How to Do Animal Rights

    Chapter 5
    The Law & Animal Rights

    How to Do Animal Rights

    Chapter 6
    Animal Statistics

    How to Do Animal Rights

    Chapter 7
    More Philosophy

    Animal rights. Just two words. Two just words.

    How to Do Animal Rights

    Chapter 8
    Animal-Human Issues (Some of Them) 

    How to Do Animal Rights

    Chapter 9

    Farm animals say no to mutilation.

    How to Do Animal Rights

    Chapter 10

    Chickens need life.

    How to Do Animal Rights

    Chapter 11

    How to Do Animal Rights

    Chapter 12
    Sundry Animal Rights Stuff

    Animal rights hits out at animal abuse.