The effect of practitioner compensation on HMO consumer satisfaction

Area of Science:

• Health Services Research
• Healthcare Management
• Consumer Behavior

Background:

• Consumer satisfaction is a key metric for health plan performance.
• Understanding factors influencing satisfaction is crucial for improving healthcare delivery.
• Practitioner compensation models are hypothesized to play a role in patient experience.

Purpose of the Study:

• To investigate the relationship between health plan practitioner compensation methods and consumer satisfaction.
• To test if specific payment structures, such as capitation or incentive-based fees, affect how satisfied members are with their health maintenance organization (HMO).

Main Methods:

• Utilized Consumer Assessment of Health Plans (CAHPS) survey data from Texas (1999-2000).
• Integrated CAHPS data with Health Plan Employer Data and Information Set (HEDIS) quality measures.
• Employed an ordered-probit model to analyze the correlation between practitioner compensation (capitated, bonus, withholding incentives) and consumer satisfaction ratings (0-10 scale).

Main Results:

• A higher percentage of practitioners compensated via capitated fees was negatively correlated with consumer satisfaction.
• A higher percentage of practitioners compensated with fee-withholding incentives showed a positive correlation with consumer satisfaction.
• Bonus incentive systems and general practitioner board certification did not significantly correlate with consumer satisfaction.

Conclusions:

• The method used by managed health plans to compensate practitioners demonstrably influences participant satisfaction.
• Fee-withholding incentives appear to be a more effective compensation strategy for enhancing member satisfaction compared to capitation or bonus systems.