John Rezen: 7 steps toward a value-based payment model for primary care

  1. Establish true patient panels for each primary care physician.
  2. Agree on the optimal percentage of the healthcare dollar that should go for primary care.
  3. Adjust each primary care team’s payments to account for the overall health status of the patient panel.
  4. Set targeted performance levels for quality based on primary care scores under the Merit-based incentive payment system (MIPS).
  5. Use national primary care patient satisfaction benchmarks to agree on targeted performance levels for service.
  6. Use current regional healthcare per-member-per-month (PMPM) costs adjusted by the patient-panel-specific RAF score to set a total cost baseline for each primary care team.
  7. Determine the total value of primary care payments for the period of service.
Notes: Notes: John Rezen, MHA, LSSBB, CRCR, is president and CEO, Value Health, Pinehurst, N.C., and a member of HFMA’s North Carolina Chapter.

Source: HFMA, June 11, 2020 - https://www.hfma.org/topics/hfm/2020/august/7-steps-toward-compensating-primary…

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