Everyone talks about quality, few pay for it

But pressure from payers and plans may mean more doctors encounter incentives based on standards other than productivity.

By Myrle Croasdale, AMNews staff. Feb. 18, 2002.

Like most medical groups, Prevea Health Services of Green Bay, Wis., uses productivity as the main segment of its physician incentive pay formula. But the clinic is wondering whether that's the best way to get the best work out of its 135 physicians.

So it's considering results from patient satisfaction surveys as a financial incentive for doctors. Jeff Young, DO, head of Prevea's pediatrics department, said this could help improve care -- and Prevea's market share.

"You can't just use productivity to [motivate] physicians," Dr. Young said. "Seeing more patients in a day doesn't mean that you're going to be a better doctor. In today's medical market, the patient needs to be treated more like a consumer, and we, unfortunately, have to see ourselves as a commodity. Patients in Green Bay have a great deal of choice. They don't have to come to Prevea."

The question of whether patient satisfaction surveys or some other quality measure should be included in determining how clinics pay doctors is one that is being asked more often, especially in larger groups such as Prevea, part of a system that includes two hospitals and a health plan.

Even health plans are getting in on the act. Late last year six California plans said they would pay individual doctors bonuses based on a standard quality-measurement system, which has yet to be created. That followed an announcement a few months earlier from WellPoint Health Networks' Blue Cross of California, which said it would pay doctors bonuses based on patient satisfaction scores. [...]