Primary care providers — physicians, nurse practitioners and physician assistants — gave alternative healthcare delivery models mixed reviews, according to a survey from The Commonwealth Fund and The Kaiser Family Foundation.
The survey measured negative feedback on the increased reliance on quality metrics and on financial penalties associated with healthcare reform. Others were frustrated by administrative burdens associated with Medicare and Medicaid.
Here are 14 key findings from the report on primary care provider's views of healthcare reform.
- A majority of NPs and PAs (87 percent) reported receiving at least some portion of payment through methods that were not fee-for-service.
- More than a third of physicians (34 percent) are paid only by fee-for-service.
- Almost a third of physicians participate in accountable care organizations (29 percent), but participation is higher among those who accept Medicare (34 percent).
- About 30 percent of physicians receive payments through a patient-centered medical home or the Advanced Primary Care Practice medical home demonstration.
- Fewer NPs and PAs reported participating in an ACO (18 percent) or in patient-centered medical home practices (26 percent).
- Almost a third of physicians (28 percent) and more than half of NPs and PAs (56 percent) are not sure if their practices are participating in an ACO.
- Less than half of physicians (33 percent) and NPs and PAs (40 percent) believe medical homes positively impact the quality of care.
- Roughly 10 percent of providers felt PCMHs were negative and about 25 percent of each group said PCMHs had no impact or they were not sure.
- More physicians felt ACO prevalence was negative (26 percent) than positive (14 percent) in affecting the quality of care.
- Among those physicians participating in ACOs, roughly one-third felt ACOs were positive, one-quarter felt they were negative and one-fifth felt they had no impact.
- Most NPs and PAs (88 percent) view team-based care as positive, compared to 29 percent of physicians.
- Among physicians with an NP or PA on staff, 40 percent felt team-based care was positive.
- Half of physicians and 38 percent of NPs and PAs feel quality metrics are getting in the way of providing quality care. Even less physicians (12 percent) and NPs and PAs (15 percent) felt financial penalties for unnecessary hospital admissions or readmissions were positive.
- Almost half of physicians (47 percent) are considering retirement due to recent healthcare trends, compared to 27 percent of NPs and PAs. However, the survey notes physician satisfaction levels have not changed much in the last 20 years.
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