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关于一家医院所属的学术型聘用医师多专科团队中激励薪酬计划的结果、认知与态度

Results, Knowledge, and Attitudes Regarding an Incentive Compensation Plan in a Hospital-Based, Academic, Employed Physician Multispecialty Group.

作者信息

Dolan Robert W, Nesto Richard, Ellender Stacey, Luccessi Christopher

机构信息

Robert W. Dolan, MD, Department of Otolaryngology-Head and Neck Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts; and Richard Nesto, MD, Stacey Ellender, PhD, and Christopher Lucchesi, Department of Decision Support Services, Division of Finance, Lahey Health, Burlington, Massachusetts.

出版信息

J Healthc Manag. 2017 Mar/Apr;62(2):120-133. doi: 10.1097/JHM-D-17-00009.

Abstract

Hospitals and healthcare systems are introducing incentive metrics into compensation plans that align with value-based payment methodologies. These incentive measures should be considered a practical application of the transition from volume to value and will likely replace traditional productivity-based compensation in the future. During the transition, there will be provider resistance and implementation challenges. This article examines a large multispecialty group's experience with a newly implemented incentive compensation plan including the structure of the plan, formulas for calculation of the payments, the mix of quality and productivity metrics, and metric threshold achievement. Three rounds of surveys with comments were collected to measure knowledge and attitudes regarding the plan. Lessons learned and specific recommendations for success are described. The participant's knowledge and attitudes regarding the plan are important considerations and affect morale and engagement. Significant provider dissatisfaction with the plan was found. Careful metric selection, design, and management are critical activities that will facilitate provider acceptance and support. Improvements in data collection and reporting will be needed to produce reliable metrics that can supplant traditional volume-based productivity measures.

摘要

医院和医疗保健系统正在将激励指标引入薪酬计划,这些指标与基于价值的支付方法相一致。这些激励措施应被视为从量到值转变的实际应用,并且未来可能会取代传统的基于生产率的薪酬方式。在转型过程中,将会遇到医疗服务提供者的抵制以及实施方面的挑战。本文考察了一个大型多专科医疗集团在新实施的激励薪酬计划方面的经验,包括该计划的结构、支付计算方式、质量和生产率指标的组合以及指标阈值的达成情况。收集了三轮带有意见的调查,以衡量对该计划的认知和态度。文中描述了所吸取的经验教训以及取得成功的具体建议。参与者对该计划的认知和态度是重要的考量因素,会影响士气和参与度。结果发现医疗服务提供者对该计划存在显著不满。谨慎选择、设计和管理指标是关键活动,这将有助于医疗服务提供者的接受和支持。需要改进数据收集和报告工作,以生成可靠的指标,从而取代传统的基于工作量的生产率衡量指标。

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