Quality: Your New Pay Yardstick

By Grandinetti, Deborah | Medical Economics, June 23, 1997 | Go to article overview

Quality: Your New Pay Yardstick


Grandinetti, Deborah, Medical Economics


Meeting standards may already get you a small bonus. In the future, your total compensation-and even your job-will be at stake.

Quality. The word seems to crop up in nearly every discussion about doctors and health care. But some groups are doing more than talking about it. They're committing large sums of money-up to 30 percent of physicians' salaries-to get doctors to focus more on patient satisfaction and preventive care.

Basing a percentage of physician pay on these so-called quality factors is nothing new. But, generally, qualitybased pay amounts to no more than 5 to 10 percent of salary. "It's low because everyone recognizes the data isn't that good," says Sue Cejka, president of Cejka & Company, a St. Louis-based healthcare recruiting and consulting firm.

Small bonuses are rarely enough to motivate physicians to change their ways, however. "We had physicians who were earning $150,000, and a $5,000 bonus wasn't significant enough to get them to concentrate on what they had to do to meet quality goals," says Charlotte, N.C., health-care consultant Joseph Levitch of Towers Perrin, a national benefits consulting firm. "They were more concerned with their productivity, which had a much larger impact on earnings."

But groups like Gallatin Medical Foundation in Downey, Calif., Prairie Medical Group in Santa Monica, Calif., and Sentara Medical Group in Virginia Beach, Va., think they've found a way to significantly reward physicians for performance on quality measures.

Gallatin: Putting the emphasis

on patient perceptions

"Look at what's going on in states like Pennsylvania and New York, which have issued risk-adjusted mortality rates for physicians and hospitals performing coronary artery bypass surgery," says internist Harry Magnes, medical director for Gallatin Medical. "It's only a matter of time before you can look up a doctor on the Internet and find out his complication and infection rates. We figured we'd better embrace quality and improve our performance so people will want to come here."

Last year, Gallatin changed its compensation formula to enable the group's 250 physicians to receive merit bonuses of up to 30 percent of their salary. Patient-satisfaction scores, based on 100 responses for each doctor, account for half the bonus. Another 20 percent is tied to organizational performance, such as whether the group meets its budget or growth targets.

The final 30 percent of the bonus is based on how well the physician performs on HEDIS measures. (HEDIS, the Health Plan Employer Data and Information Set, is a series of quality benchmarks sponsored by the National Committee for Quality Assurance.) For primary-care physicians, those quality indicators include rates of childhood immunization, breast cancer screening, and cholesterol management. Physicians also get points for participating in teaching and community service, and for being accessible to patients.

Gallatin is using easily quantified process measures to judge physicians' quality, concedes Magnes. They reflect the market's perception of what leads to quality care, rather than end results. "We still need to move from these soft measures to the outcomes that matter most to patients," he says. "Obviously, it's better to look at whether cholesterol levels are being treated and lowered, than whether they're being measured."

But even these first steps are historic, Magnes says. "The health industry has never measured clinical quality or physician consistency before."

Gallatin didn't meet its organizational goals last year; thus fewer than 40 of the 250 physicians earned bonuses of 25 percent. An equal number were given 10-percent bonuses, and the rest received 15 percent. The bonus money is drawn from the foundation's regular budget.

After a year, it's not clear to Magnes how much the bonus program has changed physician behavior. "What we can demonstrate best is that the percentage of mammograms has increased," he says. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Quality: Your New Pay Yardstick
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.