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Results, Knowledge, and Attitudes Regarding an Incentive Compensation Plan in a Hospital-Based, Academic, Employed
Robert W Dolan1, Richard Nesto, Stacey Ellender
1Robert W. Dolan, MD, Department of Otolaryngology-Head and Neck Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts; and Richard Nesto, MD, Stacey Ellender, PhD, and Christopher Lucchesi, Department of Decision Support Services, Division of Finance, Lahey Health, Burlington, Massachusetts.
Executive Summary:
Hospitals and healthcare systems are introducing incentive metrics into compensation plans that align with value-based payment methodologies. These incentive measures should be considered a practical application of the transition from volume to value and will likely replace traditional productivity-based compensation in the future. During the transition, there will be provider resistance and implementation challenges. This article examines a large multispecialty group's experience with a newly implemented incentive compensation plan including the structure of the plan, formulas for calculation of the payments, the mix of quality and productivity metrics, and metric threshold achievement. Three rounds of surveys with comments were collected to measure knowledge and attitudes regarding the plan. Lessons learned and specific recommendations for success are described. The participant's knowledge and attitudes regarding the plan are important considerations and affect morale and engagement. Significant provider dissatisfaction with the plan was found. Careful metric selection, design, and management are critical activities that will facilitate provider acceptance and support. Improvements in data collection and reporting will be needed to produce reliable metrics that can supplant traditional volume-based productivity measures.
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