ABSTRACT
SUMMARY: The US healthcare sector differs from others, particularly with regard to how its workforce is compensated. In healthcare's third-party payer system, the consumer (i.e., the patient) typically is not the one paying for the service. Moreover, the payment for a given service is negotiated by the provider and the third-party payer before the patient ever seeks care-and the payment for the same service may differ among payers and patients. To further complicate matters, myriad overlapping federal, state, and local statutes and regulations govern how providers interact with patients and each other. The challenges with compensating physicians have been amplified by the healthcare workforce shortage that was looming even before the onset of the COVID-19 pandemic. In light of these various forces in the healthcare industry, this article reviews the current ways healthcare providers are compensated and the challenges with those compensation plans. Potential approaches to remedy those challenges are described, both broadly and with specific real-world examples related to primary care and surgical specialties. Lessons learned from these approaches include ways that healthcare organizations may measure the success of a compensation plan.
Subject(s)
COVID-19 , Group Practice , COVID-19/therapy , Delivery of Health Care , Humans , Insurance, Health, Reimbursement , Pandemics , United StatesSubject(s)
Economic Competition , Government Regulation , Ownership , Private Sector/legislation & jurisprudence , Professional Practice/organization & administration , Group Practice/organization & administration , Hospital-Physician Joint Ventures , Physicians/organization & administration , Practice Management/legislation & jurisprudence , Practice Management/organization & administration , Professional Practice/economics , Professional Practice/legislation & jurisprudence , State Government , United StatesSubject(s)
Adaptation, Psychological , COVID-19 , Caregivers/psychology , Group Practice , Patient-Centered Care , Humans , New JerseyABSTRACT
AIM: The COVID-19 pandemic poses unprecedented operational challenges to nephrology divisions in every country as they cope with COVID-19-related kidney disease in addition to regular patient care. Although general approaches have been proposed, there is a lack of practical guidance for nephrology division response in a hospital facing a surge of cases. Here, we describe the specific measures that our division has taken in the hope that our experience in Singapore may be helpful to others. METHODS: Descriptive narrative. RESULTS: A compilation of operational responses to the COVID-19 pandemic taken by a nephrology division at a Singapore university hospital. CONCLUSION: Nephrology operational readiness for COVID-19 requires a clinical mindset shift from usual standard of care to a crisis exigency model that targets best outcomes for available resources. Rapid multi-disciplinary efforts that evolve flexibly with the local dynamics of the outbreak are required.