Provider Workforce & Compensation

Physician compensation pressure is becoming a sharper VBC execution risk: primary care groups are warning that downcoding, Medicare Advantage payment policy, and unresolved physician fee schedule strain are undermining clinician buy-in for value-based arrangements, especially for independent practices that lack balance-sheet flexibility. At the same time, workforce-shortage responses are moving toward scope-of-practice expansion—states are modernizing PA practice laws to expand primary care capacity—while independent physician groups are weighing private equity as a capital source, raising tension between short-term sustainability and long-term alignment with ACO/population-health incentives. For VBC stakeholders, the throughline is that model participation and performance increasingly depend on whether payment design can support frontline clinician compensation and team-based staffing, not just shared-savings opportunity (Avalere on physician payment strain; PA scope expansion).