By Emily Rappleye

Despite the industry push to value-based care, relative value units — which tie payment to volume — remain the most utilized metric in determining physician bonuses, according to a 2017 Review of Physician and Advanced Practitioner Recruiting Incentives.

The report, which is based on 3,287 physician search assignments from April 2016 through March 2017, found 39 percent of physician production bonuses were tied to value or quality. This is up 6 percentage points from 32 percent in 2015-16, reflecting the healthcare industry's shift to value-based care. This trend is expected to continue as value-based payment structures like the Medicare Access and CHIP Reauthorization Act and bundled payments begin to take hold.

But for now, the majority of physician production bonuses are based on volume-based metrics, most notably RVUs, which were taken into account for 52 percent of physician bonuses, according to the report. Other metrics included net collections (28 percent), patient encounters (14 percent) and gross billings (6 percent). Respondents were able to choose multiple options.

Among the physician searches that included quality metrics as part of the production bonus (922 searches), 21 percent of that bonus was determined by quality, which is down from 29 percent in 2015-16.