What is one of the challenges of risk-sharing contracts?

Risk-sharing contracts are designed to align the financial incentives of providers, payers, and sometimes patients. However, one significant challenge is the potential for conflicts between providers and physicians. This can arise because each party may have differing priorities and interpretations of patient care quality and cost-effectiveness.

Providers may be incentivized to reduce costs and share financial risk, whereas physicians may prioritize individual patient care, which could lead to disagreements over treatment decisions and resource allocation. Differences in how each party assesses the value of care can create tension, complicating collaborative efforts to manage patient outcomes effectively.

While other challenges exist, such as the complexities that may arise in understanding shared financial responsibility or potential for over-utilization in a poorly designed contract, the conflict of interests that risk-sharing contracts may engender between the roles of providers and physicians stands out as a fundamental challenge that can affect collaboration and care delivery.