Who participates in value-based care models? Physician characteristics and implications for value-based care

Area of Science:

• Health Services Research
• Healthcare Economics
• Medical Practice Management

Background:

• Traditional fee-for-service models are being replaced by value-based care (VBC) payment models.
• Understanding physician participation in VBC is crucial for healthcare reform.
• Physician characteristics influence engagement with new payment structures.

Purpose of the Study:

• To quantify the relationship between physician characteristics and participation in VBC payment models.
• To identify which physician specialties are more or less likely to engage in VBC.
• To inform policy recommendations for increasing VBC adoption across specialties.

Main Methods:

• Utilized the 2022 National Sample Survey of Physicians from the Association of American Medical Colleges.
• Employed logistic regression analyses to assess associations with VBC participation.
• Examined participation in Accountable Care Organizations, Primary Care First, capitation, and bundled payments.

Main Results:

• The majority of surveyed physicians participate in at least one VBC model.
• Physician specialty is a significant predictor of VBC participation.
• Compared to primary care physicians, hospital-based physicians, medical specialists, psychiatrists, and surgeons showed lower participation rates in VBC models.

Conclusions:

• A notable participation gap exists between primary care physicians and various specialist groups in VBC models.
• Specific VBC models show differential uptake among specialties, with some specialists more likely to join certain bundled payments.
• Policy interventions are needed to encourage broader specialist engagement in value-based care to align with healthcare system goals.