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When Curtis Story, MD, a solo primary care physician in Port Charlotte, Florida, first heard that Medicare would begin paying physicians for offering patients chronic care management (CCM), he was optimistic that the additional revenue would bolster his practice for work it was already doing. But more than a year later, he has yet to bill for CCM.

In the average medical practice, the burden on physicians to meet differing quality measurement standards set by payers is substantial. Commercial health plans, the Centers for Medicare & Medicaid Services (CMS) and state Medicaid managed care plans all have different metrics for evaluating quality care.

Fee-for-service medicine is on the way out. That may be hard to believe if most of your income still comes from such payments, which reward physicians for the volume of services they provide. But it’s clear that payers are increasingly emphasizing reimbursement methods that reward value, rather than volume-and that that transition is accelerating.

Physicians are some of the hardest working individuals in the country. Years of rigorous training culminate in long hours at the practice. Even physicians can overlook the importance of protecting their ability to earn a living. When something as trivial as a sprained wrist can prevent a doctor from completing their daily tasks, disability insurance becomes a real consideration.

For years, physicians have solely held the keys to health information, hoarding precious knowledge from patients because it make them feel powerful, says Daniel Sands, MD, MPH, FACP.