ASSOCIATION OF FINANCIAL INCENTIVES WITH PATIENT-CENTERED MEDICAL HOME ADOPTION AMONG PRIMARY CARE PHYSICIANS

OBJECTIVES: To understand the associations between PCMH adoption and physician compensation with characteristics of primary care practices. The National Ambulatory Medical Care Survey (NAMCS), a nationally representative, annual dataset of physician visits, was used for this study. The sample size was 1,356 physicians for 2012. METHODS: A cross-sectional study using logistic regression was performed. NAMCS variables were used to construct a medical home infrastructure score and to identify practice-level characteristics for analysis. RESULTS: 70% of physicians in the study practiced in settings with PCMH infrastructure present. Physician compensation structure and size of the practice were significantly associated with PCMH infrastructure. Financial incentives based on quality were significantiy associated with physicians' compensation structure, employment status, managed care payer mix, and regional location. CONCLUSIONS: Although the adoption of PCMH is at the highest level to date, small practice settings are lagging behind. Financial incentives for physicians appear to contribute to the adoption of PCMH.