MD Incentive Compensation

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MD Incentive Compensation

• Alexa B. Kimball, MD, MPH
• Medical Director, Mass General Physicians
  Organization

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Massachusetts General Physicians Organization
(MGPO)Organization and History

MGH 1811 Corporation
Formed in 1994 from 3 existing MGH physician
groups. Governed by a Board of Trustees, half
of whom are lay members. Includes 2,700
physicians with clinical appointments, almost
all of whom are employed by the MGPO.
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Compensation History

• Compensation plans rolled out across departments
  over past 10 years most have a productivity
  component
• Quality Incentive Program introduced in 2006
• 2 Terms per year/3 measures per term
• Departments also may have some incentive based
  plans
• Internal Performance Framework introduced as we
  moved increasingly into risk contract

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Physician Compensation IncentivesChallenges
QI program
Department
IPF
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QI HighlightsResults for Term 1, 2015

• Overall.
• 18th program term, 1,940 eligible clinicians
• Performance by measure.
• Population health management 99 met the target
• Joint Commission training 98 met the target
• Department measures 29 measures, 91 of MDs met
  their target
• Communication.
• Results in a personal email, online, and in the
  June Fruit Street Physician
• Payment is in the June paycheck

This chart may overstate results for small
groups.
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Internal Performance Framework

• Forcefield effect
• Strategy
• Trend
• Quality

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Not done yet Taskforce Recommended Principles
2014

• General
• Improve clinical care or contribute to mission
• Consistent with an ethical framework of practice
  for physicians
• Compensation
• Comp plan structures should be transparent,
  consistent and fair
• Chiefs should have some discretion over comp
  components
• Comp plans should be adjustable over time to
  market forces and support recruitment and
  retention
• Productivity measures
• Productivity incentives should be included in
  most compensation plans
• Non-productivity measures
• Measurable
• Actionable
• Adjustable

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Recommended Implementation Principles

• Incentives should be integrated in a manner that
• Improve patient care
• Minimizes administrative burden
• Leverages MGPO QI program admin structure
• Recognizes and supports diversity in compensation
  plans across and within departments
• Ideally adds at-risk compensation while
  preserving current pay
• Maintains compensation levels to recruit and
  retain world-class physicians
• Creates opportunity to phase out historical
  metrics that may be outmoded