Quality Incentive Payments: Team-based or Individualized?

Pay-for-performance programs first appeared on the health care landscape more than decade ago, and ever since then, stakeholders have been struggling with how to best reward health care professionals for their good work. Are physicians and other health care professionals best incentivized with payment based on individual-level work or with team-based compensation?

Researchers from the George Washington University (GWU) School of Nursing in Washington, D.C., and the University of Oregon's Health Policy Research Group, with offices in Portland and Salem, set out to find answers.

The research team conducted 48 in-depth interviews with clinicians in primary care clinics engaged in pay-for-performance initiatives at Fairview Health Services, a Minneapolis-based nonprofit academic health system.

The findings from that research were published in the May/June issue of Annals of Family Medicine in an article titled "Working Under a Clinic-Level Quality Incentive: Primary Care Clinicians' Perceptions.

Researchers were drawn to Fairview Health Services because of its innovative compensation model first piloted in four clinics in July 2010 and implemented clinic-wide in April 2011. Before the switch, clinicians were paid based on a fee-for-service model that included the potential to earn a $15,000 annual quality bonus.