The current disconnect between payments made to health care systems and the compensation plans of physicians employed by them is an elephant in the waiting room. Unlike the smooth pendulum swing of the 1990s from fee-for-service to global payments, there are now several new flavors of risk and most organizations are trying them all. Fee-for-service, shared savings, alternative quality contracts, bundled payments and global capitation all require a different approach to maximize value. Yet other than niche organizations that focus on one brand of risk and pair it with appropriate reimbursement, is anyone actually doing that?
