Patient attitudes toward physician financial incentives

Area of Science:

• Healthcare Economics
• Patient-Centered Care

Background:

• Physician financial incentives impact behavior, but patient perspectives are understudied.
• Understanding patient attitudes toward compensation models is crucial for healthcare system design.

Purpose of the Study:

• To evaluate patient attitudes towards different physician payment structures.
• To identify patient characteristics associated with varying levels of discomfort with these models.

Main Methods:

• A survey was distributed to 2000 adult patients within a health maintenance organization.
• Patients reported on trust in their primary care physician and discomfort with salary, fee-for-service with withhold, and capitation payment models.

Main Results:

• A majority of respondents (56%) reported discomfort with at least one payment model, with capitation causing the most unease (53%).
• Discomfort with capitation was significantly higher among white, higher-income, and college-educated patients.
• While knowing about capitation did not reduce trust, it still led to significant patient discomfort.

Conclusions:

• A substantial portion of patients are uncomfortable with common physician compensation methods, particularly capitation.
• Patient demographics, including race, income, and education, are linked to discomfort with payment models.
• As capitation models expand, incorporating patient concerns into compensation agreement design is essential.