Evidence map›Paper›PMID 33852143›Full record

ArticleJournal of general internal medicine2022

Association of Primary Care Physician Compensation Incentives and Quality of Care in the United States, 2012-2016.

David S Burstein, David T Liss, Jeffrey A Linder

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Primary care stability as a social determinant.Frontiers in health services · 2025
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

David S BursteinFeinberg School of Medicine, Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University, Chicago, IL, USA. David.Burstein@northwestern.edu.ORCID 0000-0003-4136-7397
David T LissFeinberg School of Medicine, Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University, Chicago, IL, USA.
Jeffrey A LinderFeinberg School of Medicine, Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University, Chicago, IL, USA.

Funding

The Claude D. Pepper Older Americans Independence Center (OAIC) at Northwestern UniversityP30AG059988 · NIA · NORTHWESTERN UNIVERSITY AT CHICAGO · PI ACKERMANN, RONALD T. · 2020 to 2024
$7.1M
ToolBox Detect: Low Cost Detection of Cognitive Decline in Primary Care SettingsR01AG069762 · NIA · NORTHWESTERN UNIVERSITY AT CHICAGO · PI GERSHON, RICHARD, NOWINSKI, CINDY J. · 2020 to 2025
$6.4M
Use of Behavioral Economics in Repeat SARS-CoV-2 Antibody Testing in Disadvantaged CommunitiesR33AG057395 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI DOCTOR, JASON N., SULLIVAN, MARK D · 2019 to 2021
$3.3M
Improving Safe Antibiotic Prescribing in Telehealth: A Randomized TrialR01HS026506 · AHRQ · YALE UNIVERSITY · PI MEEKER, DANIELLA · 2018 to 2022
$2.1M
Behavioral Economics Applications to Geriatrics Leveraging EHRs (BEAGLE)R33AG057383 · NIA · NORTHWESTERN UNIVERSITY AT CHICAGO · PI PERSELL, STEPHEN · 2019 to 2021
$2.1M
The Role of Telehealth in COVID-19 ResponseR01HS028127 · AHRQ · UNIVERSITY OF SOUTHERN CALIFORNIA · PI MEEKER, DANIELLA · 2021 to 2022
$961k
AHRQ HHS HHSP233201500020IAHRQ HHS R01 HS026506AHRQ HHS R01 HS028127NIA NIH HHS P30 AG059988NIA NIH HHS R01 AG069762NIA NIH HHS R33 AG057383NIA NIH HHS R33 AG057395
6 · The paper itself

Abstract

backgroundPhysician compensation incentives may have positive or negative effects on clinical quality.

objectiveTo assess the association between various physician compensation incentives on technical indicators of primary care quality.

designCross-sectional, nationally representative retrospective analysis.

participantsVisits by adults to primary care physicians in the National Ambulatory Medical Care Survey from 2012-2016. We analyzed 49,580 sampled visits, representing 1.45 billion primary care visits. MAIN MEASURES: We assessed the association between 5 compensation incentives - quality measure performance, patient experience scores, individual productivity, practice financial performance, or practice efficiency - and 10 high-value and 7 low-value care measures as well as high-value and low-value care composites. KEY

resultsQuality measure performance was an incentive in 22% of visits; patient experience scores, 17%; individual productivity, 57%; practice financial performance, 63%; and practice efficiency, 12%. In adjusted models, none of the compensation incentives were consistently associated with individual high- and low-value measures. None of the compensation incentives were associated with high- or low-value care composites. For example, quality measure performance compensation was not significantly associated with high-value care (visits with quality incentive, 47% of eligible measures met; without quality incentive, 43%; adjusted odds ratio [aOR], 1.02; 95% confidence interval [CI], 0.91 to 1.15) or low-value care (aOR, 0.99; 95% CI, 0.82-1.19). Physician compensation incentives that might be expected to increase low-value care did not: patient experience (aOR for low-value care composite, 0.83; 95% CI, 0.65-1.05), individual productivity (aOR, 1.03; 95% CI, 0.88-1.22), and practice financial performance (aOR, 1.05; 95% CI, 0.81-1.36).

conclusionIn this retrospective, cross-sectional, nationally representative analysis of care in the United States, physician compensation incentives were not generally associated with more or less high- or low-value care.

Indexed as

MotivationPhysicians, Primary CareAdultCross-Sectional StudiesHumansPhysician Incentive PlansQuality of Health CareRetrospective StudiesUnited StatesIncentivesPhysician CompensationPrimary CareQuality of Care

Identifiers

PMID33852143
PMCPMC8811085

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.