Research ArticleOriginal Research

Impact of a Primary Care Value-Based Compensation Model

Lindsey Ulin, Lisa Rotenstein, Richard Gitomer, Lipika Samal, Salina Bakshi, Lance Rachelefsky, John Lewis and Erin E. Sullivan
The Journal of the American Board of Family Medicine September 2026, 39 (1) 168431; DOI: https://doi.org/10.3122/jabfm.2025.250220R2

Article Figures & Data

Figures

  • Trends in Absolute Panel Size Across the Center of Excellence and Percentage Changes in Panel Growth Rate by YearPanel Growth Rate is defined as ((Year End Panel – Year End Panel of Prior Year)/Year End Panel of Prior Year). This measure was used since organizational accountabilities were based on the rate of panel growth for BWH Primary Care.Abbreviations: RVU = relative value unit
    Figure 1. Trends in Absolute Panel Size Across the Center of Excellence and Percentage Changes in Panel Growth Rate by Year

    Panel Growth Rate is defined as ((Year End Panel – Year End Panel of Prior Year)/Year End Panel of Prior Year). This measure was used since organizational accountabilities were based on the rate of panel growth for BWH Primary Care.

    Abbreviations: RVU = relative value unit

Tables

  • Table 1. RVU vs. Value-Based Compensation Model: Key Differences
    ElementRVU-Based Compensation ModelValue-Based–Compensation Model
    Panel size target 1800 patients1800 patients, with adjustment for social complexity, medical complexity, and percent of the panel comprised of female patients
    Determinant of PCP Compensation Number of wRVUs achieved in prior fiscal yearCombination of fixed component based on cFTE, adjusted panel size, seniority of physician, achievement of adjusted panel size target
    Visit Length 20 minute visits for existing patients, 40 minute visits for new patients30 minutes for all visit types
    Yearly Visit Target NoneFloor set for number of visits expected that each PCP deliver yearly, normalized to their cFTE

    Abbreviations: RVU = relative value unit, wRVU = work relative value unit, PCP = primary care physician, cFTE = clinical full time equivalent

    • Table 2. Compensation Components for PCPs in Value-Based Compensation Model
      ComponentAverage Proportion of Total Compensation*
      Fixed normalized to cFTE61%
      Panel size: Adjusted for social complexity, medical complexity, and percent of the panel comprised of female patients.27%
      Seniority: Additional compensation based on each sequential year post-residency. 6%
      Citizenship normalized to cFTE: Compensation based on PCPs engaging in 2-3 activities that were of priority to the organization (eg, attending clinic meetings, encounter completion within a specified period) in each fiscal year.3%
      Panel bonus normalized to cFTE (distributed twice yearly): Based on achieving target panel threshold relative to each physicians’ cFTE allocation3%

      *Average proportions of compensation noted here are based on a physician with 15 years of experience with an average size panel and clinical FTE. Exact proportions may vary by clinical effort, panel size, and years of experience.

      Abbreviations: cFTE = clinical full time equivalent, PCP = primary care physician

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