KevinMD July 24, 2025
She works for a not-for-profit health system, but nothing about what she described to me felt charitable. A young physician, just a few years into her career, she’s already facing a choice that no doctor should ever have to make: protect her patients or protect the metrics that determine her employer’s paycheck.
The heart of the problem
This physician works under a value-based payment model. On paper, it sounds great: Pay doctors for better outcomes instead of more visits. In reality, these contracts often encourage data manipulation and cherry-picking patients to hit performance targets.
She told me about a meeting with a mid-level manager who reviewed her quality metrics and suggested she “remove” certain high-risk patients from her panel. These...
Today's Sponsors
Today's Sponsor