A case study of a team-based, quality-focused compensation model for primary care providers

Med Care Res Rev. 2014 Jun;71(3):207-23. doi: 10.1177/1077558713506749. Epub 2013 Nov 13.


In 2011, Fairview Health Services began replacing their fee-for-service compensation model for primary care providers (PCPs), which included an annual pay-for-performance bonus, with a team-based model designed to improve quality of care, patient experience, and (eventually) cost containment. In-depth interviews and an online survey of PCPs early after implementation of the new model suggest that it quickly changed the way many PCPs practiced. Most PCPs reported a shift in orientation toward quality of care, working more collaboratively with their colleagues and focusing on their full panel of patients. The majority reported that their quality of care had improved because of the model and that their colleagues' quality had to. The comprehensive change did, however, result in lower fee-for-service billing and reductions in PCP satisfaction. While Fairview's compensation model is still a work in progress, their early experiences can provide lessons for other delivery systems seeking to reform PCP compensation.

Keywords: financial incentives; primary care provider compensation; quality of care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost Control
  • Humans
  • Interviews as Topic
  • Models, Organizational
  • Organizational Case Studies
  • Patient Care Team / economics*
  • Patient Care Team / organization & administration
  • Patient Care Team / standards
  • Physicians, Primary Care / economics*
  • Physicians, Primary Care / organization & administration
  • Practice Patterns, Physicians' / economics
  • Practice Patterns, Physicians' / organization & administration
  • Quality Improvement / economics
  • Quality Improvement / organization & administration
  • Quality Improvement / standards
  • Quality of Health Care / economics*
  • Quality of Health Care / organization & administration
  • Quality of Health Care / standards
  • Salaries and Fringe Benefits*