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Stethoscope and money Although most compensation arrangements included performance-based incentives, they averaged less than 10% of total compensation. (Photo: Shutterstock)

Despite the promise of value-based care, the current compensation structure continues to incentivize physicians for volume.

A payment hierarchy exists in the U.S. health care system. Reimbursement mechanisms used by payers create incentives for health systems and physician organizations. In turn, these organizations create incentives for physicians through compensation packages, which may or may not reflect the same structure and incentives as those they face from payers. Evidence suggests that physician organizations are selective in which incentives they pass along to physicians.

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