10 Potential Time Bombs in Your Employment Contract

Leigh Page


October 22, 2015

In This Article

5. Your Compensation Is Value-Based

Although most compensation and bonus arrangements are tied to productivity, some hospital systems and large groups are beginning to peg pay to value-based measurements.

These are such metrics as clinical outcomes, patient satisfaction, adoption of electronic health records, and use of recommended screenings. Pay may also be tied to different forms of compensation, such as case rates, bundled payments, global capitation, and shared savings.

Whether the shift to value-based metrics is good or bad depends entirely on your own preferences, Stadler says. If you think productivity goals push you too hard, then you might prefer to be judged by outcomes. On the other hand, if you enjoy a fast-paced practice, you might miss having productivity measures.

Moreover, Gosfield says, moving to a value-based system may force you to fundamentally change your practice style. For example, "in a capitated model, you would want healthy patients, and a value-based model might base compensation partly on patient satisfaction," she says. "Your practice might not be geared to meet this new measurement."

Another potential problem: The organization may phase in a value-based system after you start the job and, on the basis of the provisions in your contract, it may have total authority to do so. To deal with this possibility, "the contract should state how a change in payment models would be addressed," Gosfield says.


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