title: Development and Impact of a Novel Academic Primary Care Compensation Model.
abstract: BACKGROUND
  Traditional productivity-based compensation models do not align well with newer population-based approaches to primary care. There are few published examples of academic general internal medicine compensation models that explicitly reward population health management, including care for patients between visits.
  
  
  OBJECTIVE
  To describe the development and implementation of an academic general internal medicine compensation plan based upon actual work performed, compare satisfaction across primary care specialties, and evaluate work-related outcomes.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Forty-seven general internists who practice in affiliated academic and community clinics.
  
  
  METHODS
  Clinician satisfaction with compensation plan, workforce stability, panel data, and productivity.
  
  
  RESULTS
  The compensation plan change was associated with higher provider satisfaction. Sixty-five percent (31/47) of participants within general internal medicine reported being satisfied or very satisfied, as compared to 24 % (22/90 participants) for family medicine and 22 % (5/23 participants) for general pediatrics (p < 0.05). In the first 4 years of the compensation plan change, no general internists left to join other local groups. General internal medicine increased its number of physicians by 19 %. The number of established general internists accepting new patients increased from 17 to 48 %, while the relative value units per full-time equivalent declined by 3 %.
  
  
  CONCLUSIONS
  An equitable compensation model that aligns with population management goals and work performed outside the clinical visit can lead to improved satisfaction and retention of faculty in an academic general internal medicine division, along with improved access for the patient population.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 2828 Marshall Court, Suite 100, Madison, WI, 53705, USA. brt@medicine.wisc.edu.|Primary Care Academics Transforming Healthcare Collaborative, UW Health, Madison, WI, USA. brt@medicine.wisc.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Trowbridge
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Bartels
authors.affiliation: Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Primary Care Academics Transforming Healthcare Collaborative, UW Health, Madison, WI, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Koslov
authors.affiliation: Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Primary Care Academics Transforming Healthcare Collaborative, UW Health, Madison, WI, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Kamnetz
authors.affiliation: Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Primary Care Academics Transforming Healthcare Collaborative, UW Health, Madison, WI, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Pandhi
mesh_terms: D000046:Academic Medical Centers / Q000191:economics*; D001291:Attitude of Health Personnel; D004526:Efficiency; D006302:Health Services Research / Q000379:methods; D006801:Humans; D007388:Internal Medicine / Q000191:economics; D007396:Internship and Residency / Q000191:economics; D007588:Job Satisfaction; D017059:Models, Econometric; D010563:Personnel Turnover / Q000706:statistics & numerical data; D010816:Physician Incentive Plans; D058007:Physicians, Primary Care / Q000191:economics / Q000523:psychology; D011320:Primary Health Care / Q000191:economics*; D012456:Salaries and Fringe Benefits / Q000191:economics*; D014922:Wisconsin
keywords: Physician satisfaction; Primary care; Workforce