The redesign of the nation’s healthcare delivery system is setting up for another wave of change. And this one’s certain to fuel public relations challenges for healthcare PR professionals with both internal and external audiences.

The prospect of connecting doctors’ income directly to quality of care is already sparking lively discussions. What the New York Times describes as “a bold experiment in performance pay,” NYC hospitals and doctors are negotiating a new compensation arrangement.

“The proposal represents a broad national push away from the traditional model of rewarding doctors for the volume of services they order, a system that has been criticized for promoting unnecessary treatment,” according to the Times.

This and other news coverage raises public awareness—and industry attention—to the increased emphasis on patient outcomes, satisfaction and cost containment. The general consumer public has long been aware of, and often uses, the various online physician rating and review sites such as Healthgrades, Consumer Reports, and many others. And hospitals are adjusting to healthcare reform measures that connect patient satisfaction scores to compensation. [See: The $1 Billion Hospital Pay-for-Performance Incentive.]

But under this proposal, financial compensation would now be more directly tied to “the front line, the doctors directly responsible for treatment.” The quality measures being discussed include various performance indicators such as doctor-patient communications, readmissions for some conditions, length of time in the emergency room and how quickly patients are discharged.

Understandably, doctors are concerned that “they could be penalized for conditions they cannot control, including how clean the hospital floors are, the attentiveness of nurses and the availability of beds.”

New York’s large public hospital system could be creating a model compensation arrangement… certainly one that that other health systems will be watching. The Times quotes Dr. Bruce Siegel, president of the National Association of Public Hospitals and Health Systems as calling the plan “unprecedented for American public hospitals, in terms of scale, in terms of moving us into a new model.”

Healthcare public relations professionals will also be watching how the proposed New York program plays out. The recent Times article suggests that doctor-pay-for-performance is a topic of significant concern to both providers and hospitals. And it is likely to be at the core of continuing PR challenges in coming months.