Effect of physician-specific pay-for-performance incentives in a large group practice

Area of Science:

• Health Services Research
• Medical Economics
• Quality Improvement

Background:

• Group practices are increasingly adopting pay-for-performance (PFP) programs to enhance healthcare quality.
• The shift from group-focused to physician-specific incentives represents a significant change in PFP strategy.

Purpose of the Study:

• To evaluate the impact of a physician-specific PFP program on quality-of-care metrics within a large group practice.
• To compare the effectiveness of individual-based incentives against group-based incentives.

Main Methods:

• A multispecialty group practice transitioned to physician-specific PFP incentives in 2007.
• Nine incentivized clinical measures and five non-incentivized measures were analyzed.
• Quality scores were calculated as (Patients Meeting Target / Eligible Patients) x 100 and compared year-over-year.

Main Results:

• Eight of nine incentivized measures demonstrated significant improvement from 2006 to 2007.
• Three measures showed a significantly improved trend compared to the prior year.
• One non-incentivized measure also exhibited a similar improvement trend.

Conclusions:

• Small, physician-specific financial incentives ($5000/year maximum) may sustain or enhance improvements in ambulatory care quality.
• The impact of physician-specific incentives was not demonstrably superior to other quality improvement strategies with different incentive focuses.