Volumes drop but pay survives under value model

ATLANTA—Have healthcare reform and the shift from volume-based to value-based compensation had an impact on cardiovascular practices? A report from MedAxiom released at the Cardiovascular Service Line Symposium in Atlanta suggests they have.

“With the passage of the Affordable Care Act and the move toward accountable care and populations, the industry is feeling the need for safety in numbers,” according to the 2013 MedAxiom Provider Compensation & Production Survey. Integrated practices now surpass private groups, at 78 to 45, based on survey results from MedAxiom members.

Pressures to decrease volume have impacted cardiology practice; nonetheless, compensation for almost all specialties is on the rise. With the exception of general, noninvasive cardiology, median compensation in recent years increased for all specialties—yet median relative value units (RVUs) mostly remained flat.

Imaging and interventional cardiology may be the poster children for the shift from volume to value. Between 2008 and 2012, the ratio of imaging tests to new patients declined from 67.4 percent to 50.6 percent. Catheterization procedures also dropped. An analysis of total procedures and total cognitive encounters showed the ratio dipping from 6.7 percent in 2008 to 5.2 percent in 2012.

“While this may not seem like much it represents a 22 percent decrease and when you consider scale it takes on perspective … the ratio change results in nearly 700 fewer catheterizations per year for the median group,” according to the report.

The survey compiled data from MedAxiom’s resources for a report that may serve as a benchmark for cardiovascular practices under healthcare reform.