NC Plenary: Transformation Through Leadership: Multi-Payer Alignment in Transforming to Shared Accountability in North Carolina

For provider practices, the movement from fee-for-service to value payment (either Category 3 or 4) involves infrastructure investments and changes in care delivery that require significant resources. While alternative payment models are based on the premise of financial rewards for providers who achieve lower costs and high quality, the reality for many providers is that these incentives are either funneled back into the practice infrastructure or otherwise do not trickle down to the individual physician level. Behavioral economics can be applied to the design and implementation of incentives (financial and non-financial) for front-line physicians – i.e. cascading down from the organizational level.

This session will feature speakers discussing the following questions:

  • How are incentives designed within the practice, and how does this design vary by practice size, type, and the timing of availability of data?
  • What are the non-financial incentives – i.e. intrinsic factors – that motivate physicians to implement behavior change that supports the goal of improving outcomes and reducing costs?
  • What effect – if any – do these incentive designs have on clinician behavior, and how can practices (and payers, if possible) sustain behavior change?
  • What can the field consider as it designs incentives (both financial and non-financial) based on the early experiences of category 3 and 4 practices?
  • How can APMs that are based on care teams that cut across primary and specialty care providers be designed in a way so as to not create positive incentives for one type of clinician, and disincentives for another?

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