Many small groups are already incorporating some form of productivity into their compensation systems.

Physicians may keep what they bring in after expenses, or they may receive a share of the total group revenue after expenses based on the revenue they brought in or their share of relative value units (RVUs).  Large groups, on the other hand, seem more likely to base physician pay on industry data and salary surveys. The problem with handing physicians a paycheck with no strings attached is that it can reduce motivation. “A lot of groups don’t base pay on any kind of productivity, then they wonder why the physician is not productive,” said S. McGraw, principle with The Health Care Group Inc., a consulting firm in Plymouth Meeting, Pa.  As a result, practices that have historically paid pure salaries or split revenue equally are beginning to add measures of productivity into their salary plans. Physicians may not always eat what they kill, but their salaries are increasingly being affected by what they bring to the table in terms of  charges or collections.