Reference no: EM133435019
Maplesville Internal Medicine is a physician group practice located in a small city (population 150,000) in the Southwest. Maplesville's eight physicians include family physicians, internists and pediatricians. The practice is owned by two of the physicians; the other six are currently salaried. The owners are concerned with the quality and productivity in the practice. There is a relatively long waiting time for appointments, and a recent chart review revealed that the percentage of the children who are up to date with immunizations has dropped. Also, anecdotal evidence suggests that at risk people are not routinely receiving flu and pneumonia vaccinations. Many patients have complained about having to wait up to 90 minutes in the waiting room. At this time, however the practice is not in a position to hire another physician. Currently, each physician sees an average of 25 patients per day. The owners want this number to increase to 30 patients a day without sacrificing the quality of care. To reach this goal, they are thinking of moving to an incentive program, whereby physicians have a base salary equivalent to 75% of their current salary and have the opportunity to earn up to 125% of their base salary if they meet the defined volume and quality goals.
Although the owners have not completely thought this system through, they want to set 30 patients a day as a base and through an incentive program, encourage physicians to see on average up to 35 patients a day. In terms of quality, the owners have considered the following three measures: (1) patients satisfaction surveys, (2) child immunization audits, and (3) patients waiting times. Quality goals will be set biannually for each physician. The expectation is that physicians who achieve the goals will earn their full salaries (assuming patient volume is adequate), and quality measures above their goals will result in bonuses according to a pay schedule.
You have been brought into to advice the owners on their proposed compensation plan.
Do you see any potentially negative consequences of this plan bases on the information provided? If so, how would you address these concerns?
How do you think the physicians in the practice would react to this plan? Should they be involved in developing this plan? And if so, how should they be involved?
What advice would you offer to the owners before they proceed?