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Family Physicians with Value-Based Payment Models Experience Less Burnout, According to Study from AAFP with Elation Health

Independent research shows family physicians with 75% revenue derived from value-based payment models experience fewer burnout symptoms; defines essential elements to transition to value-based payments

SAN FRANCISCO, October 25, 2023 / PR Newswire / – Elation Health, the clinical-first technology company powering innovation in primary care, announced today that the American Academy of Family Physicians (AAFP) Innovation Lab, which identifies key innovations that optimize the family medicine experience, has issued the results of a second collaborative study. The goal of the study this year, conducted by surveying 10 primary care practices of varying sizes, was to identify specific barriers and innovations required for mainstream adoption of value-based payment (VBP) models and their relationship to physician burnout. 

Access the full report here.

“Value-based care holds much promise by creating supportive collaborations between patient and physician, improving quality of care, and reducing healthcare spending,” said Dr. Steven Waldren, MD, MS, chief medical informatics officer at AAFP. “In this second study with Elation Health, we found it critical to further explore the challenges family physicians face as they work to transition to value-based payment models and to understand which innovations help them break through these barriers without putting themselves at risk of burnout.”

According to another recent AAFP study, more than half of family physicians report being burned out. In this most recent study, among physicians facing burnout, the study cohort with the most severe symptoms had a majority of their revenue from fee-for-service payment models, while the cohort with little to no burnout had 75% or more revenue from VBP arrangements. This indicates that payment models likely have a significant impact on physician burnout. 

Key findings from the study illustrate both the promise and the challenges involved with VBP models. The following themes emerged:

  • Infrastructure: A significant factor in burnout is the amount of work to be done related to the resources available to efficiently do the work. The study uncovered a threshold of financial investment needed to support adequate infrastructure to enable success in VBP and reduce the associated risk of burnout. In larger practices or in practices with network affiliations, economies of scale made VBP administration more manageable. Beyond human resources, the adoption of technical solutions supported operational efficiencies, helping contain operating expenses and enabling clinical and financial success. 

  • Capitation Factors: Practices with capitated models, or risk-adjusted, per-person payment models, experienced less burnout than those with payment models designed around retrospective “bonus” payments. The study also replicated findings that higher capitation rates combined with the greater percent of total revenue from capitation can most effectively relieve physician burnout. 

  • Quality Measures: The effort required to identify, deliver, report, and get paid for a set of payer-driven quality measures is proportionally high for the majority of practices, regardless of size. The study showed that practices with fewer payer contracts had less burnout, given its link to fewer or simpler workflows to achieve success.

  • Payer-Practice Contract Quality and Innovation: The most successful practices in the study benefited from innovative and savvy contract design between the practice and the health plan, sometimes involving partner health systems. Practice leaders who worked closely with payer organizations to design contracts around the power of primary care to influence downstream utilization patterns and costs of care of an attributed population realized better financial outcomes for the practice, reported a better experience of delivering care, and enjoyed the least amount of burnout. 

“The study affirms what we see on a daily basis at Elation Health: while fee-for-service payment saddles clinicians with excess administrative burden, alternative payment models have the potential to make this even worse when poorly implemented. This has a profound impact on physician wellbeing and contributes to burnout across the primary care landscape,” said Dr. Sara Pastoor, senior director of primary care advancement at Elation Health. “While the movement toward value-based payment holds great promise and is better for patients, payers, and primary care, these new incentive programs may contain their own challenges. We’re encouraged to see that innovations focused on the unique needs of primary care are easing the burden and responsibilities that contribute to burnout, making the adoption of value-based payment models a more attractive prospect.”


The study interviewed 10 primary care physicians who are in VBP arrangements. The participant practices varied in size, ranging from solo physicians to larger practices of 25 and 50 clinicians, and including one corporate VBP organization. Interviews were conducted via teleconference and based on a structured interview survey guide. The interview guide captured quantitative, qualitative, and verbatim responses. 

To learn more about Elation Health and AAFP Innovation Labs, visit here. To learn more about Elation’s unified clinical and billing solution, visit here and to hear about Innovation Lab’s progress, join us in Chicago at AAFP’s annual FMX event at booth #1925, October 26–29, 2023.


About Elation Health

Elation Health is the most trusted technology platform for high-value primary care. Since 2010, the company has delivered clinical-first solutions — built on a collaborative EHR platform — that help primary care organizations start, grow, and succeed in delivering the highest-quality personalized care to patients. Elation supports the mission of primary care by providing technology solutions that ease burden and allow physicians to focus on caring for their patients. The company serves 30,000 clinicians caring for more than three million Americans, including thousands of small independent practices and large prominent digital health innovators. Elation Health is looking ahead to another year of advancement after securing $50 million in Series D funding in 2022, with plans to continue investing in technology and services as they rapidly scale. Learn more at, LinkedIn, and X. 

About American Academy of Family Physicians (AAFP)

Founded in 1947, the AAFP represents 127,600 physicians and medical students nationwide. It is the largest medical society devoted solely to primary care. Family physicians conduct approximately one in five office visits — that’s 192 million visits annually or 48% more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care. To learn more about the specialty of family medicine, AAFP’s positions on issues, and clinical care, visit For information about healthcare, health conditions, and wellness, please visit AAFP’s consumer website,