How 10 leading health systems pay their doctors

Healthc (Amst). 2015 Jun;3(2):60-2. doi: 10.1016/j.hjdsi.2014.11.004. Epub 2014 Dec 16.


We conducted interviews with senior executives at 10 leading health systems to better understand how organizations use performance-based compensation. Of the organizations interviewed, five pay physicians using productivity-independent salaries, and five use productivity-adjusted salaries. Performance-based pay is more prevalent in primary care than in subspecialties, and the most consistently identified performance domains are quality, service, productivity, and citizenship. Most organizations have less than 10% of total compensation at risk, with payments distributed across three to five domains, each containing several metrics. Approaches with many metrics--and little at-risk compensation for each metric-may offer weak incentive to achieve any particular goal.

Keywords: Incentives; Performance-based compensation; Productivity; Provider organization; Quality improvement; Value-based healthcare delivery.

MeSH terms

  • Efficiency
  • Humans
  • Physician Incentive Plans
  • Physicians*
  • Primary Health Care
  • Reimbursement, Incentive
  • Salaries and Fringe Benefits*
  • United States