For instance, in a practice that gives strong emphasis to quality formulas, the physicians who score high on quality will earn more, while those who score low may end up leaving. If they are replaced by high-quality physicians, the practice's referrals will strengthen over time. Physicians who do well on quality measures demand higher pay, he adds. Such measures need groups of at least five physicians because of the costs of setting up and running them, Peck says. Excellent data are needed.
Some payers offer higher compensation to groups that do well on quality measures.
In Orlando, the Central Florida Health Care Coalition, a large multiemployer health plan that includes Walt Disney World, may raise its reimbursements and cut copays for the best groups, and cut reimbursements and raise copays for the worst groups. Executive director Becky Cherney says implementation will take several years. PGPP physicians' costs have risen about half as fast as other physicians' costs, Alliance says. Whether the extra pay to groups ends up in physician paychecks, and whether it does so denominated as production pay or quality pay, are of course separate questions. Quality pay measures come in four main categories.