An incentive pay plan is defined as part of a compensation strategy that awards high productivity with more and better pays. Institutions either utilize organizational or individual performance to determine the incentives to give their employees. In the healthcare system, the relative value units (RVUs) are used to assess physician fee plans. This paper explores the various clinical performance measures used to examine nurse practitioners’ productivity and the external motivators and business models that explain incentive payment for care.
Patient satisfaction scores are important in providing information on quality measures. Al-Neyadi, Abdallah and Malik (2018) state that patient satisfaction is a vital clinical performance measure for healthcare practitioners such as nurses. Rhodes, Bechtle and McNett (2015) stipulate that once hospitals have enhanced quality, they have higher customer service scores, an increase in patient access, and more staff. Patient satisfaction scores measure quality since the indicator affects aspects such as medical malpractice claims, patient retention and loyalty, and clinical outcomes. It is, therefore, imperative to evaluate the importance of utilizing these scores. First, they help in recognizing weaknesses in the healthcare setting. For instance, patient dissatisfaction can indicate that the facility did not meet their specific standards. Second, patient satisfaction scores aid in identifying areas of improvement. Assessing this aspect provides information on why the patient was dissatisfied, and if the claim is substantiated, the healthcare facility may improve (Rhodes et al., 2015). Third, patient satisfaction scores can help an organization prevent the misuse, underuse, or overuse of healthcare services. Importantly, they aid in recognizing cases of disparities in care delivery among the population.
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Various performance measures are used for nurse practitioners’ productivity in Rhodes et al. (2015) article. According to Rhodes et al. (2015), both quality and productivity metrics are utilized when evaluating the incentive plan to use among advanced practice registered nurses (APRNs). The authors indicate that a benchmark is used to assess the productivity of nurses and is dependent on specialty and chosen by the director of the department of nursing (Rhodes et al., 2015). The benchmarks were then used as the median to compare the different results. To begin with, a three-year rolling average was utilized to minimize the fluctuations of the year to year results. Moreover, each APRN was assigned a percentage effort in the fields of patient care. Additionally, the billing reports were used as performance measures of productivity. These indicators help in determining nurse practitioners’ productivity.
Vroom’s expectancy theory can assist in identifying the external motivators in incentive payment for care. Lloyd and Mertens (2018) state that this model is based on the supposition that people have choices and tend to make decisions depending on the alternative that gives them a higher personal outcome. According to the theory, motivation is steered by three factors, including expectancy, which indicates an individual’s belief that increasing their effort will enhance their accomplishment. Instrumentality is when a person believes that there is a link between the goal and reward. For instance, when they suppose that an increase in their productivity will be rewarded. Valence indicates the extent to which an individual values success and the reward. In intensive payment for care, the expectancy model shows that external motivators such as monetary bonuses and compensation for activities beyond duties can enhance the nurses’ motivation to the extent where they perceive it to satisfy their personal goals and to the point where they consider their reward to be dependent on their performance. Moreover, the theory suggests that consistent rewards and equity motivate people. For instance, people will be prompted to work harder when they perceive their efforts to be equally rewarded. This model provides insights into how nurses can be driven.
The Alderfer’s ERG model assists in identifying the external motivators in incentive payment for care. Dunlop (2018) indicates that the ERG theory is classified into three distinct categories, including existence, relatedness, and growth. The external motivators in the existence category include safe working conditions, paid off time, benefits, and compensation programs (Dunlop, 2018). Nurses are bound to improve their quality and productivity when they are provided with such motivators. When these motivators are attained, they may stop motivating them. Those in the relatedness section include positive work relationships, feeling part of a team, and fitting in with the work culture. The external motivators in the growth category include self-pride in one’s work, awards, realizing one’s dream job, and recognition (Dunlop, 2018). According to this theory, a nurse that has attained the existence and relatedness factors can only be motivated by the growth strategies. This model suggests that when a person moves from one category, the motivators in that segment cease to inspire them. Employers should, thus, seek to understand the hierarchy of needs of their employees continually. For instance, safe working conditions may stop motivating a health practitioner but the introduction of positive working relationships can be introduced to re-motivate them.
In conclusion, quality and productivity are among the critical elements evaluated in incentive payment in care. Various performance measures are used to show whether a nurse is providing proper health services. Moreover, different external motivators suggested by the Vroom’s expectancy theory and the Alderfer’s ERG model can be used in incentive payment for care. Monetary bonuses, compensation, safe working conditions, and quality relationships are among the primary motivators for motivating nurses. This paper has provided insights into the importance of using these indicators when incentivizing nurses.
References
Al-Neyadi, H. S., Abdallah, S., & Malik, M. (2016). Measuring patient’s satisfaction with healthcare services in the UAE hospitals: Using SERVQUAL. International Journal of Healthcare Management, 11(2), 96-105.
Dunlop, M. (2018). The Synergy between Psychology and Business: A Case Study on Interdisciplinary Faculty Collaboration. International Journal of Business and Applied Social Science , 4 (6), 52-56.
Lloyd, R. A., & Mertens, D. (2018). Expecting more out of Expectancy Theory: History urges inclusion of the social context. International Management Review , 14 (1), 28-43.
Rhodes, C. A., Bechtle, M., & McNett, M. (2015). An incentive pay plan for advanced practice registered nurses: impact on provider and organizational outcomes. Nursing Economics, 33(3), 125.
