Can Sharing ENT Performance Bonuses With Staff Pay Off?

As more and more of a practice’s income comes from payments related to meeting specific goals such as quality measures and patient satisfaction scores, the question of how to divide the money among members of the practice becomes an increasingly important consideration, especially in those areas where staff participation can impact the amount of bonus income the practice receives.

With lower reimbursements and the spiraling costs of providing care, physicians may be tempted to keep much of this “new money” for themselves. Given the impact staff interactions can have a on how well the practice does, however, this may turn out to be penny wise but pound foolish.

“It is well established that staff have a tremendous impact on services provided by a doctor’s office,” said Mary Witt, senior vice president at The Camden Group, a health care management and consulting company based in El Segundo, Calif. “For example, patient satisfaction surveys have a number of questions that aren’t related to the physician. Activities like how well the phones are answered and the experience during signing in at the office are a result of staff behaviors.”

Employee Impact

“These models now mean that physician reimbursement will be based on more than whether or not I treat a patient right. It will also hinge on staff and their interactions.”

—Joe F. Smith, MD

Studies of hospital employees have shown that unsatisfied health care employees negatively affect the quality of care. This, in turn, adversely impacts patient satisfaction and loyalty—a possible double financial whammy as both governmental and private payers roll out programs paying separate incentives for quality and satisfaction (J Health Care Mark. 1996:16;14-23).

“It has to be understood that no doctor can do their work without staff,” said David Hunter, MD, FACS, senior partner of Oklahoma City Ear, Nose, and Throat Clinic in Oklahoma City. “You always have to think about ways to give employees a reason to be conscientious and stay on the job.”

The problem then becomes finding the best way to incentivize the staff to fulfill their part of the myriad new quality and patient satisfaction goals for which the practice is responsible. At the same time, practices still have to be able to keep the doors open and the doctors paid. Part of the confusion stems from the many ways bonuses and other incentives are being paid to the practice.

“The change to pay-for-performance doesn’t always mean new money is coming to the practice,” said Ron Seifert, vice president and health care consultant with the Hay Group in Philadelphia. “While some private payers may give bonuses for meeting certain goals, others may just not give a practice as much of a yearly increase as they do those who make their targets.”