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Review
. 2022 Dec;121(4):280-284.

Does a Change in Physician Compensation Lead to Changes in Care Delivery in Family Medicine Clinics?

Jennifer Lochner  1   2 , Jen Birstler  3 , Maureen A Smith  4   2 , Paul Rathouz  5 , Brian Arndt  4   2 , Mark Micek  6   2 , Elizabeth Trowbridge  6   2 , Elizabeth Trowbridge  6   2 , Sandra Kamnetz  4   2 , Nancy Pandhi  7   2
Affiliations
Review

Does a Change in Physician Compensation Lead to Changes in Care Delivery in Family Medicine Clinics?

Jennifer Lochner et al. WMJ. 2022 Dec.

Abstract

Background and objectives: Many highly capitated systems still pay physicians based on relative value units (RVU), which may lead to excessive office visits. We reviewed electronic health records from the family medicine clinic panel members of 97 physicians and 42 residents to determine if a change from RVUs to panel-based compensation influenced care delivery as defined by the number of office visits and telephone contacts per panel member per month.

Methods: A retrospective analysis of the electronic health records of patients seen in 4 residency training clinics, 10 community clinics, and 4 regional clinics was conducted. We assessed face-to-face care delivery and telephone call volume for the clinics individually and for the clinics pooled by clinic type from 1 year before to at least 1 year after the change.

Results: Change in physician compensation was not found to have an effect on office visits or telephone calls per panel member per month when pooled by clinic categories. Some significant effects were seen in individual clinics without any clear patterns by clinic size or type.

Conclusions: Change in physician compensation was not a key driver of care delivery in family medicine clinics. Understanding changes in care delivery may require looking at a broad array of system, physician, and patient factors.

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Conflict of interest statement

Conflict of Interest Disclosure: The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Interrupted Time Series Study Design. Change in level = b2; change in slope (post minus pre) = b3.
Figure 2.
Figure 2.
Office Visits per Panel Member per Month
Figure 3.
Figure 3.
Telephone Calls per Panel Member per Month
Figure 4.
Figure 4.
b2 and b3 Results for Office Visits per Panel Member per Month
Figure 5.
Figure 5.
b2 and b3 Results for Telephone Calls per Panel Member per Month
See this image and copyright information in PMC

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