- 28 percent of Michigan primary care physicians reported participation in at least one innovative compensation model.
- 41 percent of physicians reported expecting fee-for-service payments to decline, while 44 percent and 42 percent reported expecting fee-for-service with incentives and bundled payments (respectively) to increase as a percentage of their practice revenue over the next 1–3 years.
- The Michigan Primary Care Transformation Project (MiPCT) was the value-based payment initiative that physicians in Michigan reported participating in most frequently in 2014.
- Bundled payments were uncommon at the time of the survey: on average, physicians reported that only 3 percent of their practice revenue came from bundled payments, and only 5 percent of physicians reported participation in the Bundled Payments for Care Improvement initiative.
A substantial share of Michigan primary care physicians reported anticipating a shift from fee-forservice to other forms of payment in the near future. When asked about expectations for changes in sources of practice revenue over the next 1–3 years, 54 percent of physicians expected at least one alternative to fee-for-service to increase. Thirty-seven percent of respondents reported receiving at least half their practice revenue from fee-for-service payments at the time of the survey and expected fee-for-service to comprise a similar or greater share of their practice revenue in the future.
Fourty-four percent of respondents expected fee-for-service with incentives to increase, 31 percent of respondents expected capitation to increase, 42 percent of respondents expected bundled payments to increase, and 41 percent of respondents expected fee-forservice to decline. Figure 3
Physicians who reported participating in MiPCT were 51 percent more likely to expect a decline in fee-for-service payments than those not participating in MiPCT.
The survey data presented in this brief were produced from a mail survey of 1,000 primary care physicians practicing in Michigan, conducted between December 2013 and April 2014. Potential respondents received up to three mailings, with $5 included in the first mailing to encourage response.
The physician sample was randomly generated from the American Medical Association (AMA) Physician Masterfile, a comprehensive list that includes both AMA members and non-members. The final sample included physicians from two primary care specialties: family medicine and internal medicine. The survey had a response rate of 36 percent (317 physicians) and has a margin of error of ±5.5 percent. Physicians who responded but reported they were no longer practicing primary care were removed from the analysis. Physicians who reported that they were unsure whether they participated in an innovative compensation model or that they were not participating at the time of the survey but planned to do so in the future were considered as non-participants for the purpose of this analysis. Results were analyzed using SAS 9.3 software.
Statistical significance of bivariate relationships was tested using z tests or chi-square tests for independence. All reported differences are statistically significant at p ≤ 0.05 unless otherwise noted.
Suggested Citation: Smiley, Mary L.; Ndukwe, Ezinne G.; Riba, Melissa; Udow-Phillips, Marianne. Primary Care Physician Perspectives on Innovative Compensation Models. 2014 Michigan Physician Survey (Ann Arbor, MI: Center for Healthcare Research and Transformation, 2015).
Acknowledgements: The staff at the Center for Healthcare Research & Transformation would like to thank Thomas Buchmueller, Matthew M. Davis, Robert Goodman, Helen Levy, Renuka Tipirneni, and the staff of the Institute for Public Policy and Social Research (IPPSR) at Michigan State University for their assistance with the design and analysis of the survey.