The Academy Lumeris - Strategic Survey Q4 2018: The Evolving Payment Model & Physician Alignment

Key Findings

  1. In Q4 2018, Leading Health Systems reported that fee-for-service payments account for 77% of total care delivery, while value-based payments account for 23% of care delivery.
  2. Half (50%) of health systems indicate the pace of change toward value-based care is happening quickly or very quickly.
  3. Leading Health Systems report primary care physicians have a higher percent of compensation tied to value-based metrics (17%) compared to specialists (10%).


As the percentage of care delivered through risk-bearing payment arrangements continues to grow, health systems are implementing strategies to increase organizational alignment around quality and cost goals. To improve alignment, health systems are integrating value-based metrics such as quality, satisfaction, and access into their physician compensation models.

In Q4 2018, The Health Management Academy (The Academy) conducted an assessment of Leading Health Systems to understand organizations’ evolving payment models and identify strategies for increasing physician alignment.


In November 2018, The Academy conducted the seventeenth round of phone interviews for its quarterly strategic survey among Leading Health System executives, including: CEOs, COOs, CFOs, CMOs, CNOs, and CSOs.

The survey for the interview consisted of:

  1. A tracking section that provides insight into trends around primary strategic areas; and
  2. A special topic area that allows for an in-depth look into a timely developing issue.