Hospitalists and compensation incentives based on quality – what do we know?

By  |  July 2, 2009 | 

John Nelson writes…

Since SHM has began gathering data in 1997, the majority of hospitalists have shifted from a fixed, or “straight,” compensation, to a compensation method that includes a variable component based on performance.  Productivity, as measured in things like RVUs or encounters, is the most common variable element, but quality metrics used as a basis for a portion of compensation are rapidly gaining in popularity.

In late 2008, SHM’s Practice Analysis Committee conducted a survey focused on hospitalist turnover and participation in quality initiativesOf the 115 groups responding, 96% indicated that their group participates in quality initiatives at their hospital, most commonly serving on quality-related committees at the hospital.  You probably want to make sure that your group isn’t in the 4% that don’t work on quality initiatives.

A more remarkable fact from the survey is that “97% of respondents also indicated at least one individual in the group has a formally designated quality role within the hospital or health system (such as Chief Quality Officer, Patient Safety Officer, Medical Director for Case Management, etc.); 86% of such positions involve dedicated time and pay for this work.”

More than half of groups responding to the survey (58%) reported that a portion of hospitalist compensation is based on performance on quality initiatives.  Of these, 97% had less than 20% of annual compensation connected to quality, and nearly half (43%) had <7% of annual pay connected to quality.

Remarkably, 64% of groups responding indicated that the quality-related compensation was paid based on individual, rather than group, performance.  That is, within the same group one hospitalist might be compensated for a high score on a quality metric while someone else in the same group might be paid less for a lower score on the same metric.  This is surprising because so many quality metrics, like core measures and patient satisfaction, are difficult to connect to a single hospitalist’s performance.

About the Author:


Related Posts

By  | March 7, 2018 |  0
I am angry. Perhaps, you are too. As a physician, it is heart-wrenching to watch people unnecessarily die from gun violence. As a mom, it strikes fear in my heart to know that our nation’s children are not safe in our schools. I vividly remember being a resident on call in the ICU when I […]
By  | February 28, 2018 |  0
“We are playing the same sport, but a different game,” the wise, thoughtful emergency medicine attending physician once told me. “I am playing speed chess – I need to make a move quickly, or I lose – no matter what. My moves have to be right, but they don’t always necessarily need to be the […]
By  | February 26, 2018 |  0
The sudden resignation of White House staff secretary Rob Porter got me to thinking. Let me say up front this post isn’t about politics. And by the time it gets uploaded, our national ten-minute news cycle will probably have moved on to some other world crisis or titillating disclosure and people will be saying, “Rob […]

Leave A Comment