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Patients' attitudes toward cost control bonuses for managed care physicians
T H Gallagher1, R F St Peter, M Chesney
1Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, USA.
Health Affairs (Project Hope)
|March 23, 2001
Summary
Patients find physician financial incentives concerning. Most believe cost control bonuses are a bad idea, but a combined quality and cost bonus is viewed more favorably. Disclosure of all bonuses is highly favored.
Area of Science:
- Health economics
- Medical ethics
- Patient advocacy
Background:
- Physician financial incentives for cost containment can create conflicts of interest.
- Understanding patient perspectives on these incentives is crucial for ethical healthcare delivery.
- Limited resources in healthcare necessitate exploring cost-effective practices.
Purpose of the Study:
- To investigate patient views on physician financial incentives, specifically cost control bonuses.
- To assess patient reception of a combined cost control and quality bonus.
- To determine patient preference for the disclosure of such financial incentives.
Main Methods:
- Survey of 1,050 patients regarding their opinions on physician financial incentives.
- Analysis of patient responses to hypothetical cost control and combined cost/quality bonus scenarios.
- Evaluation of patient support for bonus disclosure.
Main Results:
- A significant majority (73%) of patients considered a cost control bonus a negative concept.
- Nearly half (49%) of patients viewed a combined cost control and quality bonus more positively than a cost-only bonus.
- Overwhelmingly, 91% of patients supported the disclosure of physician bonuses.
Conclusions:
- Patients perceive physician financial bonuses, particularly those focused solely on cost control, with apprehension.
- Incorporating a quality component into financial incentives can mitigate some patient concerns, but not all.
- Open dialogue between health plans, physicians, and patients regarding resource limitations and financial incentives is essential to address patient worries.