Managed Care

Achieving quality measures yields high bonuses for U.K. physicians

General practitioners in the United Kingdom make an average of £55,000 (about $108,000) each year, but incentives for improved quality, achieving clinical goals, and better services — including better appointment systems — can result in bonuses amounting to £47,000 ($92,000), according to a new contract between the National Health Service and the British Medical Association. U.S. internists made $157,000 each, on average, in 2005. The NHS provides most of health care in the U.K., from primary care to emergency departments, long-term care, and dentistry.

A poll conducted by Harris Interactive shows how extensively quality incentives are used to pay physicians in the United States and other countries. Primary care physicians in Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States were polled about the use of pay-for-performance incentives to improve quality.

More than 90 percent of United Kingdom primary care doctors can receive payments based on some measure of the quality of care they provide, compared to only 30 percent of U.S. doctors.

United States lags in paying for quality

Percent that receive financial incentive*

Achieving certain clinical care targets

Receiving high ratings for patient satisfaction

Managing patients with chronic disease/complex needs

Engaging in enhanced preventive care activities

Participating in quality improvement activities

*Receive or have the potential to receive

Source: 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians

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