The impact of remuneration, extrinsic and intrinsic incentives on interprofessional primary care teams: results from a rapid scoping review.

backgroundHigh-performing primary care relies on effective interprofessional teams and provider payment arrangements. This study aims to examine the impact of provider remuneration mechanisms and intrinsic and extrinsic incentives in team-based primary care.

methodsThis rapid scoping review assessed various provider payment models and incentives in team-based primary care. Statistical tests were not applicable in this review.

resultsFee-for-service models hindered team collaboration, while salaried and quality-based compensation models enhanced collaboration. Extrinsic incentives, such as pay-for-performance programs for physicians, showed mixed impacts on outcomes. Strong organizational cultures and leadership, resources, team meetings, training, clear protocols, and professional development opportunities facilitated teamwork. Intrinsic incentives like autonomy, mastery, and social purpose improved team performance and satisfaction.

conclusionsThis study underscores the importance of a holistic approach to designing interprofessional primary care teams. It highlights the need for implementing non-fee-for-service provider payment models and team-based pay-for-performance incentives. Investments in teams should include health human resources and leadership, training, guidelines, and professional development opportunities. Implementing a performance measurement framework for teams and regular public reporting can foster mastery. Continuous research and evaluation are crucial to optimizing teamwork and healthcare delivery in primary care settings.