Paying physicians in advanced managed care markets.

Physician compensation in managed care environments has undergone dramatic change over the last five to 10 years. Early goals that originally involved reduction in unit price have been replaced by a variety of variable pay formulas for primary care physicians and specialists alike. Criteria for determining provider variable pay include demonstrable member access, patient satisfaction, and economic performance. Based on emerging trends, physician payment should be modified to include measurements based on productivity and quality of life.