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REPORT DOCUMENTATION *• «bpokt no. z. X Recipient's Acculoii No. PAGE 4. Title and Subtitle S. Report Data A Study of Factors Affecting Physician Remuneration in Staff January 18, 1993 Model HMOs and Group Practices *» 7. Authorts) ft. Performing Organization Rapt. No. Julie A. iSchoenman, Ph.D. 9. Performing Organisation Nam* and Addrats luL Protect/Ti»k/Horn Unit No. Project HOPE 99-C-9916H/03-03 Center for Health Affairs 11. ContrecttO or GrantfG) No. Two Wisconsin Circle, Suite 500 (O Chew Chase. MD 20815 12. SponsoringOrganizationNam*andAddrets IX Typeof Report & Period Covered Health Care Financing Administration ORD/OR/DRES/ISB Final Report Oak Meadows Bldg, Rm 2-B-14 Me 6325 Security Blvd. Baltimore, MD 21207 IS. Supplementary Notes IX Abstract (Umrfc 200words) This study examined the nature and extent of physician payment differentials in a variety of physician employment settings. Phase I examined physician payment mechanisms in staff model health maintenance organizations (HMOs) through telephone interviews with the universe of staff model HMOs. Phase II consisted of a mail survey of small sample of physician group practices. The purpose was to identify criteria that physicians have accepted as important determinants of their income. The results obtained in Phase I indicated that years of experience, specialty, administrative duties, and board certification status were by far the most important determinants of physician base salaries. Productivity, volume, and quality of care were used more frequently in determination of bonus payments. Results of the Phase II survey of group practices show that revenue generated for the group was the most frequently used determinant of remuneration; compensation for administrative duties and years of experience with the group were also relatively common criteria. 17. Document Analysis s. Descriptors Health Care services Physician Income X Identifiers/OpervEnded Terms Health maintenance organizations physician group practices COSATt Field/Group ix Availability statement No restriction. Distribution IX Security Class (This Report) 21. No. of Pages available from National Technical Information unclassified 91 Service, Springfield, VA 22161 20. Security Class (This Page) 22. Price unclassifi^H (Formerly NTIS-35) DepartmentofCommerce A STUDY OF FACTORS AFFECTING PHYSICIAN REMUNERATION IN STAFF MODEL HMOS AND GROUP PRACTICES Final Report January 18, 1993 Submitted to: Health Care Financing Administration Office of Research Oak Meadows Building 634 Security Boulevard Baltimore, Maryland 21207 Under Cooperative Agreement No. 99-C-99168/3 Submitted by: Project HOPE Center for Health Affairs Two Wisconsin Circle, Suite 500 Chevy Chase, Maryland 20815 Principal Investigator: Julie A. Schoenman, Ph.D. TABLE OF CONTENTS Page ACKNOWLEDGEMENTS iii 1.0 PROJECT OVERVIEW 1 2.0 SURVEY METHODOLOGY 2 2.1 Instrument Development 2 2.2 Sample Selection 3 2.3 Field Methodology 4 3.0 SURVEY RESULTS 5 3.1 Response Rates and Description of Respondents.. 5 3.2 Overall Compensation Methods 5 3.3 Use of Specific Criteria to Determine Base Salary and Bonus 7 3.3.1 Use of "Volume" and "Productivity" as Payment Criteria 7 3.3.2 Use of "Experience" as a Payment Criterion 14 3.3.3 Use of Administrative Duties as a Payment Criterion 15 3.3.4 Use of Patient Satisfaction, Quality of Care, and Practice Guidelines as Payment Criteria 15 3.3.5 Use of Other Criteria 16 4.0 DISCUSSION 16 i I TABLE OF CONTENTS (CONTINUED) Page List of Tables Table 1. Sample Selection Rates by Type of Legal Organization 3 Table 2. Survey Response Rates and Characteristics of Responding Groups, by Group's Type of Legal Organization 6 Table 3. Overall Compensation Methods for Employee and Shareholding Physicians 8 Table 4. Use of Specific Compensation Criteria for Employee and Shareholding Physicians 9 Table 5. Number of Groups Making Adjustments to Compensation for Individual Physician's Differential Use of Group Resources 13 ii