Thus, practices have to decide the circumstances under which they can give the staff extra money, how much to pitch into the pot and the best way to distribute it to the employees. Done poorly, an incentive plan can be counterproductive, undermining efficiency and morale. It can be hard for employees to be nice on the phone if they think they are not being treated fairly.
Explore This IssueJune 2013
Divide and Dole Out
The first hurdle is whether a practice can afford to pay anything extra. “I am a firm believer that you don’t give bonuses when you don’t have money to give bonuses,” said Witt.
It is also very important to figure out how much the bonus is actually worth. Participation in some patient satisfaction programs, for instance, may require overhead such as an outside firm to administer and track the surveys. These extra costs to physicians should be repaid before thinking about other uses.
Another question to be considered early in the process is how to divide the remaining money. One way is to look at the measures for the bonus and split the money between the physicians and the staff based on the percentages of the criteria for which each was responsible. Using this method would mean that if the physicians were the focus of 70 percent of the survey, they would get 70 percent of the bonus.
If there is already a standing method to divide up money for other bonuses, such as meeting revenue or profit targets for the practice, these could also be used in this instance. Make sure that the staff understands the process, regardless of the method chosen.
“When changing from paying for volume to paying for quality and satisfaction, we need to consider putting at least some of the money into a pool for staff,” said Joe F. Smith, MD, an otolaryngologist with ENTcare in Dothan, Ala. “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.”
Actually dividing up any money available, whether from “new money” bonuses or from incremental increases in general reimbursements, is another decision management will have to make. For example, many practices have bonus programs for employees based on the practice meeting certain revenue and/or income performance targets.
To the extent that successfully meeting quality or satisfaction goals impacts reimbursement directly, this would be a good way to reward and incentivize your staff. Make sure that the criteria for meeting these milestones is incorporated into their employee performance targets.