Compensation Plan Questions

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Experiential Exercises Case Mapleton Family Medicine is a set 30 patients per day as a base and, through physician group practice the incentive system, encourage physicians to located in a small city (population 150,000) in see, on average, up to 35 patients per day. the Midwest. Mapleton is an eight-physician In terms of quality, the owners have practice consisting of family physicians, inter- considered three measures: nists, and pediatricians. The practice is owned by two of the physicians; the other six physicians 1. Patient satisfaction surveys are salaried. The owners are concerned with 2. Child immunization audit data productivity and quality in the practice. The 3. Patient waiting times waiting time for appointments is relatively long, and a recent chart review revealed that the per- Quality goals will be set biannually for each centage of children who are up-to-date with physician. The expectation is that physicians immunizations has dropped. Also, anecdotal who achieve these goals will earn their full evidence suggests that at-risk persons are not salary assuming volume is adequate), and routinely receiving flu and pneumonia vaccina- quality measures above these goals will result tions. Many patients have complained about in bonuses according to a pay schedule. having to wait up to 90 minutes in the waiting room. At this time, however, the practice is not Case Questions in a position to hire another physician. 1. You have been brought in to advise Each physician in the practice sees an the owners on their proposed average of 25 patients per day. The owners compensation plan. What advice will want this number increased to 30 patients you give them before they proceed? per day without sacrificing quality of care. To 2. Do you see any potential negative reach this goal, they are thinking of moving consequences of this plan based on the to an incentive system whereby physicians information provided? If so, how will have a base salary equivalent to 75 percent of you address these concerns? their current salary and have the opportunity 3. How do you think the physicians in the to earn up to 125 percent of their base sal- practice will react to this plan? Should ary if they meet defined volume and quality they be involved in developing the plan, goals. While the owners have not completely and if so, how should they be involved? thought this system through, they want to Droiect As noted in the chapter, task is to identify two healthcare organiza-
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