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Physician bonuses: tarnished awards?

J A Marcille

    Managed Care (Langhorne, Pa.)
    |February 7, 1994
    PubMed
    Summary

    Physician bonuses rewarding managed care profit targets incentivize reduced patient care. Bonuses based on patient satisfaction measure service, not true quality, despite their increasing prevalence.

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    Area of Science:

    • Health Economics
    • Medical Practice Management
    • Quality of Care Assessment

    Background:

    • Managed care plans increasingly utilize financial incentives for physicians.
    • Physician compensation models are evolving, impacting healthcare delivery.
    • Evaluating the effectiveness and implications of novel physician payment structures is critical.

    Purpose of the Study:

    • To analyze the impact of managed care financial incentives on physician behavior.
    • To critically assess the validity of patient satisfaction surveys as quality metrics.
    • To examine the trend of widespread adoption of potentially flawed physician payment systems.

    Main Methods:

    • Review of managed care contracts and incentive structures.
    • Analysis of studies correlating bonus structures with care utilization and patient outcomes.
    • Comparative assessment of profit/utilization targets versus patient satisfaction metrics.

    Main Results:

    • Bonuses tied to profit or utilization targets correlate with reduced patient care.
    • Patient satisfaction bonuses reflect service levels, not clinical quality.
    • These incentive systems are expanding across the healthcare landscape.

    Conclusions:

    • Current physician bonus systems in managed care are fundamentally flawed.
    • Incentives based on profit or utilization may compromise patient well-being.
    • Patient satisfaction is an inadequate proxy for assessing physician quality.

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