In 2014, two studies took the pulse of how physicians are responding to the transition to value-based care. An ORC International study commissioned by McKesson, “The State of Value-based Reimbursement and the Transition from Volume to Value,” revealed that the shift is taking place much more rapidly than many realized, indicating that pay for performance (P4P) will comprise over 20% of reimbursement in five years, and that 22% of providers believed that P4P would be extremely difficult to implement. A Deloitte survey around the same time, “Preparing for the inevitable: The path to physician success in a value-based world,”(PDF, 495 KB) showed that physicians expect at least 50% of their compensation to be value-based in the next ten years, even though they strongly prefer the status quo.

In other words, physicians—like many in health care—expect that big changes are coming but are reluctant to see that as a good thing.

Why would that be a surprise? Many in health care feel vulnerable right now. Physicians will be taking on more risk with the shift to value-based care while having less say in how the quality of their work will be measured. As physicians, we are competitive by nature and don't like being measured or judged by others. Additionally, we understand that health care is a $3 trillion industry and that most studies say about half of that is waste. People in general and physicians in particular realize that we can't continue in this direction but are understandably worried about the money that will be pulled away.

Here are five strategies to gain more buy-in from physicians on a transition that all agree is absolutely essential.

Technology 1. Use technology as a carrot to clinician engagement. Designed right, technology can automate much of the complexity in value-based reimbursement, helping to reduce the amount of paper physicians manage. On the technology front, value-based care should be a welcome change that allows physicians to do more practicing of medicine and less processing and paperwork.



Partner 
2. Partner with a physician leader. A physician leader such as a medical director can champion technology by helping other doctors understand what's being measured and why it is meaningful.



Transparency 
3. Be transparent. Successful programs are transparent about what the measurements are, why they were chosen and what they reveal. This helps physicians see that they are being measured fairly.



Data 4. Engage with the data. It helps when doctors are involved in the measurements instead of simply being told that it's happening. Urge them to be active in the process of capturing necessary data so they get their hands on it. When they get up close with the metrics, they'll have a better understanding—maybe even an “aha” moment—of how it impacts them and why it matters to the patient and the payer.



Team 5. Recruit tech savvy generations. Institutions like health care are hard to change, and veteran doctors can be even more resistant. But medical students are showing a great deal of interest in and receptiveness to a value-based approach. New practitioners are also more excited about using and leveraging technology and are more inclined toward collaboration and a teamwork model. In other words, medical school graduates beginning their practice are well-positioned to help our industry drive the necessary changes.

For physicians who have embraced the shift, I recommend they become well-versed on the nuances of the change and help to lead us through it faster. Form groups to discuss the new health care environment. Help others understand where they fit in. Meet with the administration and offer to advocate. Physicians and the industry as a whole have a lot to gain the more involved we become.

This blog post originally appeared on McKesson's BetterHealth2020 blog.

David Nace

About the author

Dr. David Nace is vice president and medical director at McKesson Health Solutions. He is a nationally recognized leader with expertise in health care technology, health care reform and the patient-centered medical home.