A  Deloitte survey shows that while physicians on average expect about half of their compensation to come from value-based payment models in the next 10 years, 78 percent still prefer pay-for-service models to value-based ones. That is, of course, but they expect  pay cuts from value-based models. American physicians are by far the highest paid in the world, and the prospect of big reductions because of a new cost-conscious environment is understandably scary to many of them.

The Deloitte survey indicated that many of the physicians surveyed fear that they’ll be financially penalized for factors out of their control, or that some important performance measures  that might benefit them will  be ignored.

For some time, physicians have complained about lack of transparency in data sets, benchmarking and risk-adjustment methodologies in value-based payment systems.

It goes without saying that a lack of cooperation by physicians  in implementing value-based payment systems would greatly slow  efforts to curb medical costs in the U.S., which has far the highest per-capita healthcare costs but mediocre outcomes compared to other industrialized nations.