Internist Farhan Khan, MD, knows the importance of keeping an eye on the changing healthcare landscape. The reasons are twofold: to provide better care for patients and ensure that independent physician practices like his own remain financially viable.
Participating in value-based physician incentives programs is one way to accomplish these goals. For independent physician organizations, these programs are more than just about rewards. They improve patient outcomes and satisfaction while providing critical financial support.
Dr. Khan is the medical director at Professional Medical Corporation (PMC) in Flint, Michigan. Comprising 410 physicians, PMC is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Compared with other independent organizations in Michigan, “we're somewhere in the middle—we're not too small and we're not the largest. More than 95% of our physicians are independent, not employed,” said Dr. Khan. Roughly 120 physicians at PMC are primary care doctors.
Based on PMC’s goals, the Blue Cross Blue Shield of Michigan Physician Group Incentive Program (PDF) was a good fit for the group. This is because there’s a shared objective to improve patient outcomes while both helping to control unnecessary costs and support independent physicians, he explained.
One of the program’s biggest advantages is that it provides dashboards for both the physician organization and each individual practice. Those dashboards show quality measures, identify care gaps, and help practices understand where they can improve. The program also helps build workflows for reporting and addressing social drivers of health. Moreover, it provides financial incentives that help support independent practices.
On average, the program generates nearly $10 million each year for PMC’s practices, which allows independent physicians to continue investing in care teams, technology and better patient care.
Independent organizations are shrinking in many places, Dr. Khan noted. Comparatively, PMC has added more than 60 primary care physicians over the last six to seven years “because practices see the value of the support we provide."
Dashboards and consultants track quality, identify gaps
It’s a physician’s natural tendency to focus solely on clinical care. When a patient comes in, you're making a diagnosis, writing prescriptions, and caring for the patient. With so many patients to manage, it can be difficult to keep track of quality measures, said Dr. Khan.
The BCBS incentives program equips each practice with a dashboard that shows how many patients they have, where their quality scores stand, where the gaps are, and what each health plan requires.
PMC didn't stop with the dashboard. It also has practice consultants who visit practices regularly—usually every month, and sometimes even more often, said Dr. Khan. The consultants help physicians understand their scores, interpret the data, and develop workflows that fit their practice.
The consultants know that a solo physician with one or two team members has very different challenges than a five-physician practice with 20 employees.
“It's important to understand the dynamics of each practice and how to help them,” he said.
Because the practice consultants visit so frequently, they become part of the practice team, Dr. Khan continued. They build trust and become the people physicians call when they have questions about quality scores, workflows or changes in health plan requirements.
“They can pick up the phone, call them and ask them the question about these changes, and they will get the answer,” he added.
Meaningful incentives drive engagement
PMC has seen improvements across the board with its incentives program, especially with respect to physician engagement. The medical group created a Physician Group Incentive Program committee made up of practicing physicians from internal medicine, family medicine, and pediatrics.
It's a shared leadership model, Dr. Khan said. The committee reviews data at both the physician organization and practice levels, discusses challenges, and develops practical strategies for daily tasks.
PMC also encourages practices to share what works, which has been extremely valuable, he shared. Physicians regularly exchange best practice strategies with one another, and the office managers meet frequently to discuss ideas about workflows, patient care, and solving common challenges.
Learn more with the AMA about value-based care, including ways to improve data sharing and best practices for payment methods.
Physician involvement means better patient care
Like any incentive program, it can sometimes feel like extra paperwork, but “we keep reminding our practices that the purpose is to improve patient care,” said Dr. Khan, noting that patient-centered care goes beyond seeing a patient and writing a prescription.
It's about improving outcomes—making sure blood pressure is controlled, diabetes is managed, avoiding unnecessary services, lowering costs, and improving patient satisfaction. Patients recognize when their physician's office is doing more than simply treating today's problem or writing a prescription.
“One of the biggest lessons we've learned is that physician involvement matters,” he emphasized. If physicians understand why controlling blood pressure or diabetes matters and how it affects patient outcomes, that's the starting point.
Dr. Khan’s advice to other organizations is to build strong physician leadership, create committees that represent practicing physicians, provide clear performance reports, and maintain regular communication with practices. It is also important to give physicians meaningful data through dashboards, explain why the measures matter, and provide someone who can help them develop workflows and solve problems.
“When they face a challenge, there's a person who can at least show them some of the workflow or solution for their challenge,” he advised.
It takes astute clinical judgment as well as a commitment to collaboration and solving challenging problems to succeed in independent settings that are often fluid, and the AMA offers the resources and support physicians need to both start and sustain success in private practice.
Find out more about the AMA Private Practice Physicians Section, which seeks to preserve the freedom, independence and integrity of private practice.
