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Related Experiment Videos

How disclosing HMO physician incentives affects trust.

Mark A Hall1, Elizabeth Dugan, Rajesh Balkrishnan

  • 1Wake Forest University School of Medicine in Winston-Salem, North Carolina, USA.

Health Affairs (Project Hope)
|March 20, 2002
PubMed
Summary

Disclosing how health plans pay doctors, including incentives for saving money, did not decrease patient trust. This transparency actually increased knowledge about physician payment methods and had a small positive effect on trust in physicians.

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Area of Science:

  • Health Services Research
  • Health Economics
  • Medical Ethics

Background:

  • Physician payment methods, particularly those involving cost-saving incentives, are controversial.
  • Concerns exist that disclosing these payment structures may erode patient trust in physicians or health insurers.
  • Understanding the impact of transparency on trust is crucial for effective healthcare management.

Purpose of the Study:

  • To investigate the effect of disclosing physician payment methods in Health Maintenance Organizations (HMOs) on patient trust.
  • To assess whether informing patients about physician incentives influences their trust in physicians and insurers.

Main Methods:

  • Members of two similar HMO plans were randomized into intervention and control groups.
  • The intervention group received disclosures detailing how their primary care physicians were paid.
Keywords:
Empirical ApproachHealth Care and Public HealthProfessional Patient Relationship

Related Experiment Videos

  • Disclosures described either capitation payment or a mixed-incentive plan (fee-for-service with bonuses for cost savings, satisfaction, and preventive care), emphasizing positive aspects.

    • Main Results:

    • Disclosures doubled the number of participants with substantial knowledge of physician incentives and halved those with no knowledge.
    • No negative effects on trust in physicians or insurers were observed following the disclosures.
    • Disclosure for the capitated plan showed a small positive effect on trust in physicians.

    Conclusions:

    • Disclosing physician payment incentives, including both positive and negative features, does not reduce patient trust in physicians or insurers in the short term.
    • Increased knowledge of physician incentives, coupled with transparency, may foster mild positive impacts on physician trust.
    • Candor and enhanced understanding of payment structures appear to be key factors in maintaining or improving patient trust.