Revenue Cycle Management Blog | GroupOne Health Source

Medical Providers Missing Billions of Incentives

Written by Kaitlyn Houseman | May 17, 2012

New research suggests that providers are missing out on as much as $20 billion a year in incentives because their availability is poorly communicated. The study, by Illinois-based ZS Associates, concluded that up to 75 percent of incentives are going uncollected.

Provider incentives have proliferated in recent years. Altogether, there are more than 170 pay-for-performance programs nationwide, compared to just 10 in the 1990s, according to Physicians News Digest.

Although 85 percent of providers--including individual nurses and physicians--are eligible to receive some form of incentives, 75 percent were unaware of them, or unable to tease out the incentives from base payments, according to the study. And one third said the payment itself was not enough to motivate a change.

"Incentives have proven to be effective in many other settings. But they have not been executed in a way that can help change provider behavior in healthcare," Angela Bakker Lee, managing principal at ZS, said Monday in a statement.

"For example, many healthcare organizations focus on selecting the right pay-for-performance metrics in their incentives plans. They believe if they get that part right, success will follow. However, they often overlook other key principles that make incentives work. It is here where we need to correct the course," she said.

by Ron Shinkman with FierceHealthFinance