Transforming health care through research and education.
Leveraging research and education to create a society of healthy communities, where all individuals reach their highest potential for health.
Douglas A. Conrad, PhD, University of Washington
Barry Saver, MD, University of Washington
Beverly Court, MHA, PhD Candidate, University of Washington
Sarah Heath, MA, Project Research Manager, University of Washington
The effect of incentives—from the health plan/purchaser to the provider organization and from the organization to the individual physician—is the focus of a project that surveyed and interviewed key medical and professional staff within ten integrated health systems.
To assist executives and clinical leaders craft new quality-based contracting arrangements between and within organizations, Dr. Conrad and his team conducted key informant interviews of twenty-two medical group practices and nine hospitals. They also surveyed by mail thirty-six medical group practice administrators, twenty-three group practice medical directors, and eighty-four individual physicians in medical group practices. The investigators’ questions focused on the effect of financial incentives on the development and implementation of quality improvement initiatives and care management systems in medical group practices as well as the effect of financial incentives on the adoption of specific care management practices by individual physicians. The study also assessed the impact of incentives at the organization level versus incentives at the level of the individual physician as a motivator for individual physicians to adopt quality-related care management practices.
Some of the study’s preliminary findings regarding plan payment (external) incentives and physician compensation (individual-level) in medical group practices revealed that:
Although the numbers available for analysis are small, the study also suggests a possible correlation between the financial incentives offered to a medical group practice and the group’s care management practices. For example, groups with potential bonus incentives from health plans based on patient satisfaction were more likely to conduct regular assessments of patient access to urgent care.
Also among the researchers’ findings were some significant, subjective viewpoints on incentives that emerged from interviews with key informants:
In their entirety, the study’s findings are intended to assist administrators and clinical leaders:
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