Using Qopi Metrics For Physician Incentive Compensation

241 Background: Physician incentive or variable compensation (VC) models are typically based on work relative value units (wRVU). Baystate Medical Practices (BMP), a group of over 450 practitioners, is evaluating a division based pilot program for VC that, while it includes wRVUs, also includes other important performance metrics. QOPI is emerging nationally as a comprehensive method for assessing quality across oncology practices. We describe the use of QOPI measures as part of a financial incentive plan for a hospital-based oncology division.A nine member QOPI certified Oncology Division participated in a pilot VC plan with group specific targets selected based on prior below average performance. 20 overall weighting percent (10% weight per category) of the overall VC framework was linked to success in two QOPI categories; "completion of treatment summaries (RxS) within 90 days of end of chemo" and "assessment of patients' emotional well being by second office visit." Three tiers of achievement were set for each goal. For RxS completion, Tiers I, II and III were defined as completion of 15, 25, and 40% of charts respectively as measured by an internal audit. For assessment of patient emotional well being tiers were at the 75(th), 80(th), and 85(th) percentiles of national QOPI participants. A formula combining VC goals into year-end VC payout was driven by three levels of percent base salary: 8, 12, and 24% respectively. The probability of achievement of each goal was expected to be 90, 50, and 10% respectively. Educational discussions with BMP leadership were held to teach about QOPI validity in the oncology community.BMP fiscal year ends September 30, thus final numbers are pending. With systems based improvements, Tier I achievement for emotional well being and Tier II achievement for RxS completion is expected. The division is interested in using different QOPI measures for VC next year with the goal of continuous improvement in QOPI scores.QOPI metrics can be used as a quality incentive for oncologists in the setting of a VC plan. Non-oncologists can appreciate the strength of QOPI as a quality tool. With time, the combination of a QOPI program through ASCO and use of various QOPI metrics can drive continuous improvement in an oncology group.