UConn’s
new SIM survey of CT physicians found that currently only 36% of CT
physicians participate in any shared savings or ACO program. There is no
information on whether shared savings are a significant part of revenues in
even the minority of physicians who are in this payment model. Not
surprisingly, shared savings is slightly more prevalent among physician owners
of practices. This new number, based on a proper randomized survey, is far
below SIM’s questionable assertion in September 2013 that 62% of CT physicians
had shared savings contracts, and the number was growing quickly. At the time,
advocates and provider groups raised significant
concerns
about the accuracy and methodology used to generate this number.
Unfortunately, that number was used at the time to argue that shared savings
was prevalent in our state and there was no danger to including strong SIM policies
to compel the payment model across the entire state. This points out the critical
need for good, unbiased data to drive policy decision-making in CT reforms.
The survey includes other interesting information. Busting
another myth, 73% of physicians working in CT Patient-Centered Medical Homes
are from small or medium-sized practices. Thankfully a SIM steering committee
member pointed out that while only one in three physicians believe PCMHs
improve the quality of care, you would get a very different answer from
consumers. There is
strong
evidence in the literature and here in
CT’s
Medicaid program of improved quality in PCMHs. Echoing almost exactly
CDC’s
recent survey, UConn found that 73% of physicians are accepting new
Medicaid patients. This is up from 61% in a survey from before Medicaid shifted
its financial model away from risk to the current model that emphasizes quality
and care coordination.
