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Aligning incentives in health care: physician practice and health system partnership.
Clin Orthop Relat Res. 2013 Jun; 471(6):1824-31.CO

Abstract

BACKGROUND

The key to successfully aligning hospitals and physicians is financial integration and joint incentives for academic, quality, and clinical productivity. Many physician practices and health systems are moving toward closer integration, but mainly through consolidation and employment strategies.

QUESTIONS/PURPOSES

We describe a fully integrated physician and hospital relationship including an overview of an aligned funds flow process that affords the department support for clinical services and teaching, research, and administrative activity. We also describe a physician compensation model that provides incentive not only for increased clinical performance, but also quality and academic objectives.

METHODS

The content of this article was acquired through our own experience in managing the Department of Orthopaedic Surgery at the University of Pennsylvania Health System including the health system's funds flow process. Based on input from both health system leaders and the faculty, the department's compensation plan was totally redesigned to create a line-of-sight plan that credits clinical performance and academic productivity.

RESULTS

Our model is multifactorial and provides sustainable support for the department and a compensation plan that is competitive within the local market and nationally. The health system's funds flow process has enhanced alignment of the faculty and hospitals by providing compensation for nonclinical time and assists the department's growth strategies by providing funding for new faculty and gain-sharing of improved hospital margin. The implementation of the compensation plan increased productivity by 8% in its first year with no additional resources. Academic productivity in that same year was arguably at or above any other year in the department's history in terms of accepted publications, national presentations, and research grants awarded.

CONCLUSIONS

A model of complete integration between an academic department and a health system is achievable through a systematic process of mission-based support.

Authors+Show Affiliations

University of Pennsylvania Health System, Hospital of University of Pennsylvania, 2 Silverstein Pavilion, 3400 Spruce Street, Philadelphia, PA 19104, USA. scott.levin@uphs.upenn.eduNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23296749

Citation

Levin, L Scott, and Lori Gustave. "Aligning Incentives in Health Care: Physician Practice and Health System Partnership." Clinical Orthopaedics and Related Research, vol. 471, no. 6, 2013, pp. 1824-31.
Levin LS, Gustave L. Aligning incentives in health care: physician practice and health system partnership. Clin Orthop Relat Res. 2013;471(6):1824-31.
Levin, L. S., & Gustave, L. (2013). Aligning incentives in health care: physician practice and health system partnership. Clinical Orthopaedics and Related Research, 471(6), 1824-31. https://doi.org/10.1007/s11999-012-2775-8
Levin LS, Gustave L. Aligning Incentives in Health Care: Physician Practice and Health System Partnership. Clin Orthop Relat Res. 2013;471(6):1824-31. PubMed PMID: 23296749.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aligning incentives in health care: physician practice and health system partnership. AU - Levin,L Scott, AU - Gustave,Lori, PY - 2013/1/9/entrez PY - 2013/1/9/pubmed PY - 2013/6/26/medline SP - 1824 EP - 31 JF - Clinical orthopaedics and related research JO - Clin. Orthop. Relat. Res. VL - 471 IS - 6 N2 - BACKGROUND: The key to successfully aligning hospitals and physicians is financial integration and joint incentives for academic, quality, and clinical productivity. Many physician practices and health systems are moving toward closer integration, but mainly through consolidation and employment strategies. QUESTIONS/PURPOSES: We describe a fully integrated physician and hospital relationship including an overview of an aligned funds flow process that affords the department support for clinical services and teaching, research, and administrative activity. We also describe a physician compensation model that provides incentive not only for increased clinical performance, but also quality and academic objectives. METHODS: The content of this article was acquired through our own experience in managing the Department of Orthopaedic Surgery at the University of Pennsylvania Health System including the health system's funds flow process. Based on input from both health system leaders and the faculty, the department's compensation plan was totally redesigned to create a line-of-sight plan that credits clinical performance and academic productivity. RESULTS: Our model is multifactorial and provides sustainable support for the department and a compensation plan that is competitive within the local market and nationally. The health system's funds flow process has enhanced alignment of the faculty and hospitals by providing compensation for nonclinical time and assists the department's growth strategies by providing funding for new faculty and gain-sharing of improved hospital margin. The implementation of the compensation plan increased productivity by 8% in its first year with no additional resources. Academic productivity in that same year was arguably at or above any other year in the department's history in terms of accepted publications, national presentations, and research grants awarded. CONCLUSIONS: A model of complete integration between an academic department and a health system is achievable through a systematic process of mission-based support. SN - 1528-1132 UR - https://www.unboundmedicine.com/medline/citation/23296749/Aligning_incentives_in_health_care:_physician_practice_and_health_system_partnership_ L2 - https://link.springer.com/article/10.1007/s11999-012-2775-8 DB - PRIME DP - Unbound Medicine ER -