Patients' attitudes toward cost control bonuses for managed care physicians

Physicians' cost containment incentives may create conflicts of interest. T o understand how patients view these incentives, we interviewed 1,050 patie nts regarding a 10 percent cost control bonus and a combined cost control/q uality bonus. Seventy-three percent said that the cost control bonus was a bad idea; 49 percent viewed the combined bonus more favorably than the cost control bonus; and 91 percent favored disclosure of bonuses. We conclude t hat patients find bonuses worrisome and favor their disclosure. A quality c omponent reassures-some, but not all, patients. Initiating a dialogue with patients about practicing medicine in an era of limited resources may help health plans and physicians to address patients' concerns.