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Effects of compensation method on physician behaviors.
Am J Manag Care. 2001 Apr; 7(4):363-73.AJ

Abstract

OBJECTIVE

To examine physician and leader perceptions of the relationship between physician compensation and the productivity of physicians practicing in medical groups.

STUDY DESIGN

Key informant interviews identified subjects' perceptions of factors influencing physician productivity and the behavioral effects of individual financial incentives. Interview transcripts were analyzed by a team of physicians, economists, and other researchers.

STUDY POPULATION

Physicians, medical leaders, and group practice administrators (n = 114) representing 46 medical group practices in California, Oregon, Washington, and Wisconsin were interviewed.

RESULTS

Five major themes emerged: (1) Most physicians reported that financial incentives did not substantially affect their own behavior, except for productivity. However, they suggested that specific compensation models do lead to certain seemingly undesirable physician behaviors. (2) By contrast, medical group leaders reported that financial incentives do affect a variety of physician behaviors. (3) Four productivity drivers emerged: financial incentives, demand-side factors, systems and infrastructure, and other individual or group attributes. (4) Physician compensation systems are evolving toward a blend of production-based and production-neutral incentives, plus new metrics aligned with the demands of managed care. (5) Culture, size, and specialty mix are significant determinants of group physician compensation systems.

CONCLUSIONS

Compensation method is perceived to be a significant influence on physician productivity, particularly among group practice leaders. The changing context of medical practice represents another powerful "macro" lever on physician behavior.

Authors+Show Affiliations

University of Washington, Department of Health Services, 1959 NE Pacific St. Room H660, Seattle, WA 98195-7660, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11310191

Citation

Tufano, J, et al. "Effects of Compensation Method On Physician Behaviors." The American Journal of Managed Care, vol. 7, no. 4, 2001, pp. 363-73.
Tufano J, Conrad DA, Sales A, et al. Effects of compensation method on physician behaviors. Am J Manag Care. 2001;7(4):363-73.
Tufano, J., Conrad, D. A., Sales, A., Maynard, C., Noren, J., Kezirian, E., Schellhase, K. G., & Liang, S. Y. (2001). Effects of compensation method on physician behaviors. The American Journal of Managed Care, 7(4), 363-73.
Tufano J, et al. Effects of Compensation Method On Physician Behaviors. Am J Manag Care. 2001;7(4):363-73. PubMed PMID: 11310191.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of compensation method on physician behaviors. AU - Tufano,J, AU - Conrad,D A, AU - Sales,A, AU - Maynard,C, AU - Noren,J, AU - Kezirian,E, AU - Schellhase,K G, AU - Liang,S Y, PY - 2001/4/20/pubmed PY - 2001/5/22/medline PY - 2001/4/20/entrez SP - 363 EP - 73 JF - The American journal of managed care JO - Am J Manag Care VL - 7 IS - 4 N2 - OBJECTIVE: To examine physician and leader perceptions of the relationship between physician compensation and the productivity of physicians practicing in medical groups. STUDY DESIGN: Key informant interviews identified subjects' perceptions of factors influencing physician productivity and the behavioral effects of individual financial incentives. Interview transcripts were analyzed by a team of physicians, economists, and other researchers. STUDY POPULATION: Physicians, medical leaders, and group practice administrators (n = 114) representing 46 medical group practices in California, Oregon, Washington, and Wisconsin were interviewed. RESULTS: Five major themes emerged: (1) Most physicians reported that financial incentives did not substantially affect their own behavior, except for productivity. However, they suggested that specific compensation models do lead to certain seemingly undesirable physician behaviors. (2) By contrast, medical group leaders reported that financial incentives do affect a variety of physician behaviors. (3) Four productivity drivers emerged: financial incentives, demand-side factors, systems and infrastructure, and other individual or group attributes. (4) Physician compensation systems are evolving toward a blend of production-based and production-neutral incentives, plus new metrics aligned with the demands of managed care. (5) Culture, size, and specialty mix are significant determinants of group physician compensation systems. CONCLUSIONS: Compensation method is perceived to be a significant influence on physician productivity, particularly among group practice leaders. The changing context of medical practice represents another powerful "macro" lever on physician behavior. SN - 1088-0224 UR - https://www.unboundmedicine.com/medline/citation/11310191/Effects_of_compensation_method_on_physician_behaviors_ L2 - https://www.ajmc.com/pubMed.php?pii=610 DB - PRIME DP - Unbound Medicine ER -