Most Medicare ACOs refuse to share information on physician payment incentives, according to a study published in the American Journal of Public Health.
A team of researchers from New York City-based Montefiore Medical Center, City University of New York at Hunter College and national consumer group Public Citizen sought to survey the 426 Medicare ACOs participating in 2015. However, only 39 responded, despite repeated attempts to contact the organizations. The researchers noted the lack of response was the most important finding of the study.
"Since polls have shown that patients are wary of incentives for under-care, we wanted to learn more about compensation incentives that may drive physician behavior and could pose a conflict of interest," lead author Mayce Mansour, MD, a primary care physician at Mount Sinai Health System in New York City, said in a statement. Dr. Mansour was a resident at Montefiore when the research was conducted.
Of the ACOs that responded to the survey, 85 percent said primary care physician compensation was tied to quality and about half said they offered incentives for reducing the volume of services ordered for patients. Some indicated physician pay was tied to the ACO-wide bonuses or penalties achieved during a performance year.
The study authors believe Medicare ACOs should be required to publicly disclose physician financial incentives to ensure patients are not wrongly being denied care. "However, CMS has inexcusably waived the disclosure requirement for ACOs, which started contracting with Medicare in 2011 and, like HMOs, may gain financially by denying care," reads a press release on the study.
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