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Measuring the effects of managed care on physicians' perceptions of their personal financial incentives.
Inquiry. 2000 Summer; 37(2):134-45.I

Abstract

Using data from the 1997 Resurvey of Young Physicians (N = 1,549), this study examines whether several measures of physicians' contractual arrangements with health plans are associated with their perceptions of overall financial incentives to either decrease or increase the volume of services to patients. Results indicate the following factors were significantly associated with an increased likelihood of reporting an incentive to decrease services: a gatekeeper arrangement with a compensation incentive; the perception of a high risk of plan deselection for physicians with high costs; the perception that referrals received depended on the costs of care provided; communication prohibiting or discouraging the disclosure to patients of the physician's financial relationship with the health plan; receiving capitation payments from at least one plan; and employment in a health maintenance organization. Being compensated on a fee-for-service basis or receiving a salary with incentive or bonus provisions (compared to straight salary) were associated with an increased likelihood of reporting an incentive to increase services to patients. Physicians' overall methods of compensation had a relatively small impact on their perceived financial incentives compared to other statistically significant factors. Our findings suggest that physicians' self-reported, overall personal financial incentives within their practices are a valid summary measure of the heterogeneous mix of specific financial arrangements faced by most physicians.

Authors+Show Affiliations

Georgetown Public Policy Institute, Georgetown University, Washington, DC 20007, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10985108

Citation

Mitchell, J M., et al. "Measuring the Effects of Managed Care On Physicians' Perceptions of Their Personal Financial Incentives." Inquiry : a Journal of Medical Care Organization, Provision and Financing, vol. 37, no. 2, 2000, pp. 134-45.
Mitchell JM, Hadley J, Sulmasy DP, et al. Measuring the effects of managed care on physicians' perceptions of their personal financial incentives. Inquiry. 2000;37(2):134-45.
Mitchell, J. M., Hadley, J., Sulmasy, D. P., & Bloche, J. G. (2000). Measuring the effects of managed care on physicians' perceptions of their personal financial incentives. Inquiry : a Journal of Medical Care Organization, Provision and Financing, 37(2), 134-45.
Mitchell JM, et al. Measuring the Effects of Managed Care On Physicians' Perceptions of Their Personal Financial Incentives. Inquiry. 2000;37(2):134-45. PubMed PMID: 10985108.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Measuring the effects of managed care on physicians' perceptions of their personal financial incentives. AU - Mitchell,J M, AU - Hadley,J, AU - Sulmasy,D P, AU - Bloche,J G, PY - 2000/9/14/pubmed PY - 2000/9/30/medline PY - 2000/9/14/entrez SP - 134 EP - 45 JF - Inquiry : a journal of medical care organization, provision and financing JO - Inquiry VL - 37 IS - 2 N2 - Using data from the 1997 Resurvey of Young Physicians (N = 1,549), this study examines whether several measures of physicians' contractual arrangements with health plans are associated with their perceptions of overall financial incentives to either decrease or increase the volume of services to patients. Results indicate the following factors were significantly associated with an increased likelihood of reporting an incentive to decrease services: a gatekeeper arrangement with a compensation incentive; the perception of a high risk of plan deselection for physicians with high costs; the perception that referrals received depended on the costs of care provided; communication prohibiting or discouraging the disclosure to patients of the physician's financial relationship with the health plan; receiving capitation payments from at least one plan; and employment in a health maintenance organization. Being compensated on a fee-for-service basis or receiving a salary with incentive or bonus provisions (compared to straight salary) were associated with an increased likelihood of reporting an incentive to increase services to patients. Physicians' overall methods of compensation had a relatively small impact on their perceived financial incentives compared to other statistically significant factors. Our findings suggest that physicians' self-reported, overall personal financial incentives within their practices are a valid summary measure of the heterogeneous mix of specific financial arrangements faced by most physicians. SN - 0046-9580 UR - https://www.unboundmedicine.com/medline/citation/10985108/Measuring_the_effects_of_managed_care_on_physicians'_perceptions_of_their_personal_financial_incentives_ DB - PRIME DP - Unbound Medicine ER -