Attitudes toward pay-for-performance initiatives among primary care osteopathic physicians in small group practices

Robert G. Locke, Malathi Srinivasan

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Context: Pay-for-performance (P4P) programs reward physicians who meet-and electronically document - specific healthcare standards during patient encounters, incentivizing certain aspects of medical care. Although such documentation can be time consuming and technology intensive, noncompliance can result in decreased physician reimbursement. Objective: To assess the attitudes of primary care osteopathic physicians toward P4P initiatives. Methods: In 2006, a 20-item questionnaire was mailed to 1000 osteopathic physicians randomly pulled from the American Osteopathic Association database for this cross-sectional, survey-based study. Distinctions were not made between physician practice type or group size when the mailing list was compiled. Results: Two hundred thirty responses were received for a response rate of 23%. Of these respondents, 123 physicians (54%) were in primary care practices comprising fewer than five physicians. Of these practitioners, 94% felt unprepared for P4P initiatives, 81% did not have the resources for appropriate technological investments, and 75% required additional P4P education and training to respond to P4P initiatives. In addition, the 28% of respondents who used electronic medical records were almost five times more likely (odds ratio, 4.80; 95% confidence interval, 1.91-12.06) to report that they could meet P4P reporting requirements. The majority of survey respondents were skeptical that P4P would appropriately capture the quality of their work and did not believe that health outcomes should influence their reimbursement. Conclusions: Although the current study's sample size may limit generalizability, small group primary care osteopathic physicians will need assistance - both technological and educational - to meet P4P measures.

Original languageEnglish (US)
Pages (from-to)21-24
Number of pages4
JournalJournal of the American Osteopathic Association
Volume108
Issue number1
StatePublished - Jan 2008
Externally publishedYes

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Osteopathic Physicians
Incentive Reimbursement
Group Practice
Primary Care Physicians
Physicians
Electronic Health Records
Reward
Documentation
Sample Size
Primary Health Care
Cross-Sectional Studies
Odds Ratio
Surveys and Questionnaires
Databases
Confidence Intervals
Technology
Delivery of Health Care
Education
Health

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Attitudes toward pay-for-performance initiatives among primary care osteopathic physicians in small group practices",
abstract = "Context: Pay-for-performance (P4P) programs reward physicians who meet-and electronically document - specific healthcare standards during patient encounters, incentivizing certain aspects of medical care. Although such documentation can be time consuming and technology intensive, noncompliance can result in decreased physician reimbursement. Objective: To assess the attitudes of primary care osteopathic physicians toward P4P initiatives. Methods: In 2006, a 20-item questionnaire was mailed to 1000 osteopathic physicians randomly pulled from the American Osteopathic Association database for this cross-sectional, survey-based study. Distinctions were not made between physician practice type or group size when the mailing list was compiled. Results: Two hundred thirty responses were received for a response rate of 23{\%}. Of these respondents, 123 physicians (54{\%}) were in primary care practices comprising fewer than five physicians. Of these practitioners, 94{\%} felt unprepared for P4P initiatives, 81{\%} did not have the resources for appropriate technological investments, and 75{\%} required additional P4P education and training to respond to P4P initiatives. In addition, the 28{\%} of respondents who used electronic medical records were almost five times more likely (odds ratio, 4.80; 95{\%} confidence interval, 1.91-12.06) to report that they could meet P4P reporting requirements. The majority of survey respondents were skeptical that P4P would appropriately capture the quality of their work and did not believe that health outcomes should influence their reimbursement. Conclusions: Although the current study's sample size may limit generalizability, small group primary care osteopathic physicians will need assistance - both technological and educational - to meet P4P measures.",
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