Earlier this week I was reading a study about physician compensation within integrated delivery systems. We’ll get back to that, but it took me back to one of my greatest ‘sales fails’ ever.
Confession time…since I am confessing, I sometimes wear my house slippers when on a video call.
We had been chasing this business development partnership with a massive player in our space for over a year. They had the brand, an army of salespeople out talking to doctors, a way to get into places we could not go alone. A joint ‘go-to-market’ deal with them would be a game-changer for us.
Finally, they invited us out to HQ to meet with the bigwigs and we shook hands on the deal. In the cab (there is the timestamp on this story) back to the airport, we fist pumped and started talking about how many people we’d need to hire to handle the growth.
Then nothing.
More nothing.
We did all the things we had discussed with the corporate suits to get our joint offering mobilized with their sales force, but no leads materialized. We discussed, psychoanalyzed, dissected, altered, begged, and even wore our lucky socks.
A few months later, we headed to the national sales meeting to make a big push. I delivered a great presentation and killed the room…great value proposition for your clients, helps sell your product, overcomes the advantage of your biggest competitor, yada yada yada.
I felt great all day.
Until we got to the after-dinner reception.
Did I tell you this was a national sales meeting? Yep, that means some people were liquored up pretty good. One of them was one of their senior reps that I knew well. Which means I got the truth…the corporation would keep almost all the revenue we were sharing and give only a token pittance to the sale reps in their commission.
No commission means no attention, which means no sales for Timmy.
This deal was a big nothing burger for us.
Individual comp plans trump business-to-business agreements all day, every day.
How is that connected to physician comp?
The study from the RAND corporation, looking at data from November 2017 to July 2019, found that 22 health systems still pay their employed physicians predominantly on volume, not value. Volume drove 68% of the personal comp for primary care physicians and 74% for specialists.
Driving more volume was the main way docs could make more money.
I had to laugh.
We’ve regularly chronicled here the lack of real, move the needle progress from the first 12 years of value-based care since the Affordable Care Act was passed. There are many reasons we were, are, and continue to remain skeptical, but for Pete’s sake, what the heck?
The whole justification (supposedly) of health systems buying up physician practices was so the ‘integrated’ delivery system could focus on ‘value,’ not ‘volume.’ But you still pay the physicians for more fee-for-service claims?
Someone needs some lubricated truth telling here. Was there another motive?