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    Risk-contract engagement strategies should differ for independent, employed docs


    Difference #3: Employed physicians might not be as motivated by financial implications

    One advantage of working with independent physicians in a risk contract, Harris says, is that the reward associated with the risk contract will go directly to their bottom line, and therefore, their compensation.

    Employed physicians might not see such a direct tie between their performance and the financial implications.  “Independent physicians tend to feel the financial results more directly,” he says. “Often with employed physicians, the compensation arrangement with the health system will blunt those rewards from risk contracts.”

    Take a fresh look at your compensation design for employed physicians, and align it with the risk-contract objectives, says Harris. Ensure rewards flow directly to physicians, or institute proxy measures that align with the risk-contract measures and tie a big enough bonus to those measures. 

    Dialogue required

    All physicians, regardless of employment situation, will be more engaged in risk contracts if they are part of the dialogue, says Harris. “Set up discussions so that physicians can really speak together and figure out the better ways to provide care,” he says.

    To get physicians more motivated in these discussions, share performance data. For example, show them a chart illustrating how each physician is doing. Initially labeling the physicians A-F on the chart can help smooth the discussions. Each physician should be told in advance, privately, which letter corresponds to him, so that he can see where he stands relative to his peers. Over time, it may be possible to shift to revealing names, says Harris.    



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