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Investigating Physician Adaptation and Response to Financial Incentives to Improve Performance
The researchers conducted an in-depth, qualitative study of physician practices in the New England Quality of Care Alliance in Massachusetts regarding their experiences with incentive-based payment approaches. Practices in the Alliance vary along several dimensions, including the amount of revenue they earn from global payment arrangements versus fee-for-service as well as how individual physicians are compensated, academic affiliation, general financial health of the practice, staff size, geographic location and patient demographics. They conducted 7-10 in-depth interviews with providers and support staff at 6-8 practices that vary along practice-level and financial dimensions. The goal of this project was to describe in-depth, “on-the-ground” cognitive and behavioral adaptations occurring among primary care providers in response to value-based payment arrangements and to develop a preliminary typology of such adaptations that could be applied across physician practices and delivery systems to better predict, design, and implement payment reform.
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