Only 21% of primary care physicians feel they are fairly compensated, according to a new report from Pearl Health. However, primary care physicians who participate in an ACO were 56% more likely than non-ACO participants to believe they are paid fairly. ACO participants were also 15% more likely to believe that the way they generate revenue allows them to deliver holistic care.
By KATIE ADAMS

Only 21% of primary care physicians feel they are fairly compensated, according to a new report released by Pearl Health, a tech company that helps independent physician practices participate in value-based care models. For the report, the company collected survey responses from 202 primary care physicians from July 11 to October 9.

Recent data shows that the three physician specialties with the lowest compensation rates are preventive, general practice and family practice. There is some irony to this given the fact that quality primary care can significantly reduce overall healthcare expenditures in the long term, the report pointed out. One 2018 study argued that each dollar invested in primary care saves $13 in downstream costs.

However, physician practice revenue is still dominated by fee-for-service payment models, meaning that physicians are rewarded for the number of billable services they deliver to patients rather than for helping them maintain their health. Pearl’s report found that just 29% of primary care physicians believe their pay allows them to provide holistic care to their patients.

The survey also revealed that primary care physicians who participate in an accountable care organization (ACO) were 56% more likely than non-ACO participants to believe they are paid fairly. In addition, ACO participants were 15% more likely to believe that the way they generate revenue allows them to deliver holistic care.

The report argued that the switch from fee-for-service to value-based payment models can help primary care physicians spend more meaningful time with their patients. For instance, if physicians receive fixed monthly payments for coordinating care, they won’t feel as much like a hamster on a wheel who needs to see a new patient every 15 to 20 minutes.

“For too long, primary care physicians have been paid for the number of patients seen per day rather than the quality of care provided, resulting in poor outcomes, unhappy patients, and physician burnout,” said Dr. Brian Mathwich, one of the survey’s respondents.

While physicians are aware that ongoing, whole-person care results in better patient outcomes, it is difficult for them to deliver this type of care while getting paid in a way that prioritizes episodic services, another respondent pointed out.

“There is this sort of disconnect between the care we’ve been trained to give and the constraints of a clinic workday. We have an ever-increasing set of guidelines, but clinic slots have not increased proportionately,” declared Dr. Justin Porter.

A recent study concluded physicians would need nearly 27 hours per day to follow the recommended primary care guidelines for preventive, chronic disease and acute care.

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