One in six physicians in a national survey did not know whether pay-for-performance was incorporated into their compensation, according to a research letter published Oct. 14 by JAMA Internal Medicine.

Kira Ryskina, MD, of the University of Pennsylvania’s Perelman School of Medicine in Philadelphia, and colleagues decided to investigate physician awareness of incentives on a national scale by conducting a cross-sectional analysis using the 2007-2008 National Ambulatory Medical Care Survey (NAMCS).

The survey was completed by 2,545 eligible physicians who were asked whether they received compensation for quality or patient satisfaction. Percentages reported were nationally weighted data. The researchers utilized multivariate logistic regression to identify which physician and practice characteristics were independently associated with physician’s lack of awareness of incentive payments.

Results indicated that 21.5 percent were compensated for quality, while 18.7 percent were compensated for satisfaction. Sixteen percent of respondents were not sure if they received compensation for patient satisfaction, while 16.2 percent didn’t know if they were compensated for quality. Those who didn’t know were more likely to work in an urban setting or a free-standing clinic, and less likely to work in a community health setting.

“If payers want pay-for-performance programs to be more effective, they may need to ensure that physicians understand what incentives are and how they might affect their compensation,” the authors wrote.