title: Using quality oncology practice initiative metrics for physician incentive compensation.
abstract: OBJECTIVE
  To demonstrate the use of American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) measures as part of a financial incentive plan for an academic health center-based hematology-oncology division.
  
  
  METHODS
  An 11-member QOPI-certified hematology-oncology division participated in a pilot variable compensation (VC) plan with group-specific targets selected based on prior below-average performance. Twenty percent of overall VC was linked to success in two QOPI categories: completion of treatment summaries within 90 days of end of chemotherapy and assessment of patients' emotional well-being by second office visit. Three tiers of achievement were set for each goal. A formula combining VC goals into year-end payout was driven by three levels of percent base salary: 8%, 12%, and 24%, with probability of achievement of each goal of 90%, 50%, and 10%, respectively. Practice leadership was educated about QOPI acceptance in the oncology community.
  
  
  RESULTS
  The division participated in QOPI during spring and fall 2012. With systems-based improvements, 40.54% of medical records audited had treatment summaries, resulting in achievement of tier III compensation. Documentation of emotional well-being increased, yielding 63% of patient cases compliant; however, the national benchmark concurrently improved, making this insufficient to achieve tier I.
  
  
  CONCLUSIONS
  QOPI metrics can be used as a quality incentive for oncologists in a VC plan. Non-oncologists can appreciate the strength of QOPI as a quality tool. The combination of a QOPI program through ASCO and use of various QOPI metrics can drive continuous improvement in an oncology group.
authors.affiliation: Baystate Medical Center, Springfield; and Tufts University School of Medicine, Boston, MA.
authors.forename: Grace
authors.initials: G
authors.lastname: Makari-Judson
authors.forename: Tamara
authors.initials: T
authors.lastname: Wrenn
authors.forename: Wilson C
authors.initials: WC
authors.lastname: Mertens
authors.forename: Gordon
authors.initials: G
authors.lastname: Josephson
authors.forename: James A
authors.initials: JA
authors.lastname: Stewart
mesh_terms: D019337:Hematologic Neoplasms / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D008495:Medical Oncology / Q000191:economics* / Q000592:standards / Q000639:trends; D010816:Physician Incentive Plans / Q000191:economics*; D058996:Quality Improvement / Q000191:economics / Q000592:standards / Q000639:trends; D011787:Quality of Health Care / Q000191:economics* / Q000592:standards / Q000639:trends; D012052:Reimbursement, Incentive / Q000191:economics; D012955:Societies, Medical; D014481:United States