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How disclosing HMO physician incentives affects trust.
Health Aff (Millwood). 2002 Mar-Apr; 21(2):197-206.HA

Abstract

Opinions are deeply divided over whether rewarding physicians for lowering costs decreases trust in physicians or insurers. To explore the effects of disclosing physician payment methods in HMOs, members of two similar HMO plans were randomized to intervention and control groups, and the experimental arm was told how the HMO paid their primary care physician. Separate disclosures were developed for each plan, one describing primarily capitation payment, and the other (mixed-incentive plan) describing fee-for-service payment with a bonus that rewards cost savings, satisfaction, and preventive services. The disclosures pointed out more of the positive than the negative features of these incentives. We found that the disclosures doubled the number of subjects with substantial knowledge of the physician incentives and halved the number with no knowledge. Nevertheless, the disclosures had no negative effects on trust of either physicians or insurers. The capitated plan disclosure had a small positive effect on trust of physicians. Disclosing the positive and negative features of incentives and increasing knowledge of these incentives does not, in the short term, reduce trust in physicians or insurers and may have a mild positive impact on physician trust, perhaps as a consequence of displaying candor and increasing understanding of positive features.

Authors+Show Affiliations

Wake Forest University School of Medicine in Winston-Salem, North Carolina, USA.No 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

11900159

Citation

Hall, Mark A., et al. "How Disclosing HMO Physician Incentives Affects Trust." Health Affairs (Project Hope), vol. 21, no. 2, 2002, pp. 197-206.
Hall MA, Dugan E, Balkrishnan R, et al. How disclosing HMO physician incentives affects trust. Health Aff (Millwood). 2002;21(2):197-206.
Hall, M. A., Dugan, E., Balkrishnan, R., & Bradley, D. (2002). How disclosing HMO physician incentives affects trust. Health Affairs (Project Hope), 21(2), 197-206.
Hall MA, et al. How Disclosing HMO Physician Incentives Affects Trust. Health Aff (Millwood). 2002 Mar-Apr;21(2):197-206. PubMed PMID: 11900159.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How disclosing HMO physician incentives affects trust. AU - Hall,Mark A, AU - Dugan,Elizabeth, AU - Balkrishnan,Rajesh, AU - Bradley,Donald, PY - 2002/3/20/pubmed PY - 2002/3/21/medline PY - 2002/3/20/entrez KW - Empirical Approach KW - Health Care and Public Health KW - Professional Patient Relationship SP - 197 EP - 206 JF - Health affairs (Project Hope) JO - Health Aff (Millwood) VL - 21 IS - 2 N2 - Opinions are deeply divided over whether rewarding physicians for lowering costs decreases trust in physicians or insurers. To explore the effects of disclosing physician payment methods in HMOs, members of two similar HMO plans were randomized to intervention and control groups, and the experimental arm was told how the HMO paid their primary care physician. Separate disclosures were developed for each plan, one describing primarily capitation payment, and the other (mixed-incentive plan) describing fee-for-service payment with a bonus that rewards cost savings, satisfaction, and preventive services. The disclosures pointed out more of the positive than the negative features of these incentives. We found that the disclosures doubled the number of subjects with substantial knowledge of the physician incentives and halved the number with no knowledge. Nevertheless, the disclosures had no negative effects on trust of either physicians or insurers. The capitated plan disclosure had a small positive effect on trust of physicians. Disclosing the positive and negative features of incentives and increasing knowledge of these incentives does not, in the short term, reduce trust in physicians or insurers and may have a mild positive impact on physician trust, perhaps as a consequence of displaying candor and increasing understanding of positive features. SN - 0278-2715 UR - https://www.unboundmedicine.com/medline/citation/11900159/How_disclosing_HMO_physician_incentives_affects_trust_ L2 - https://www.healthaffairs.org/doi/10.1377/hlthaff.21.2.197?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -