What’s in it for me? Incentive compensation in hospital medicine
Bibliographic record
Abstract
Objective: Though salary models vary, a portion of physician compensation is often provided as a bonus, or incentive payment, based on clinical productivity measured by the relative value unit (RVU). However, many hospitalists are involved in activities beyond clinical work, either administrative or educational, that may be difficult to measure and recognize in bonus payments. Furthermore, the changing nature of physician and hospital reimbursement necessitates a focus on quality measures not incentivized in the traditional RVU model.Methods: The authors describe a compensation model in an academic hospital medicine program that was initially developed in 2010 and modified in 2013. The model incents clinical productivity and adherence to quality metrics while also promoting nonclinical academic and administrative activities.Results: Implementation of this compensation model impacted the division’s quality goals by increasing completion of discharge summaries, reconciliation of discharge medications, and placement of follow-up appointment orders upon discharge. The impact on clinical and academic productivity is less clear.Conclusions: A compensation model that accounts for academic productivity and quality goals along with clinical productivity may be useful in incentivizing hospitalists in both academic and community-based hospital medicine practices. Future work should focus on whether such a model can be used effectively to address additional targets such as reducing readmissions and preventing hospital-acquired conditions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".