Report Cards and Feedback for PCCE
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorUniversity of California, Los Angeles
About this trial
As part of UCLA Health's commitment to developing an integrated health system built on a foundation of physician-led, team-based primary care, the Department of Medicine (DOM) implemented a performance-based incentive plan called the Primary Care Clinical Excellence (PCCE) Incentive Plan.
The UCLA Health DOM Quality team is leading the implementation and evaluation of this incentive plan across the UCLA Health primary care network, with the primary goal to immediately produce improvements in the quality of primary care. In order to rigorously measure the most efficacious ways to frame and communicate information about the quality improvement (QI) program, the DOM Quality team has partnered with the UCLA Anderson School of Management.
Understanding the factors that motivate physicians to deliver high quality primary care will provide pivotal insights into the successful implementation of performance based programs nationwide.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Primary care physicians within the UCLA Health Department of Medicine Primary Care Network that are eligible for the PCCE Incentive program as of October 1, 2023.
Physicians with the clinical full-time employee level (FTE) of ≥ 40% as of October 1, 2023
Physicians with panel size >50 patients as of October 1, 2023
Disqualifiers
Physicians classified as Pediatrics will be excluded from data analysis given the structural differences in health maintenance guidelines for children.
Physicians classified as Urgent Care will be excluded from data analysis given the structural differences in their performance evaluation. They are all in Arm 1.
Physicians who participate in the design of this experiment will be excluded from analysis.
Trial design
Design model
Parallel
Treatments tested in this trial
Standard Communication Email
BehavioralThis is a standard quarterly email communication without personalized performance metrics.
Personalized Report Card Email
BehavioralThis personalized information about physician performance replaces the standard communication email to provide personalized feedback to physicians.
Bottom-Up Framing
BehavioralThe bottom-up framing is added onto the personalized communication email to provide insight on how the PCCE program was informed by physician feedback. The bottom-up framing is added onto the survey communication to provide insight on how the PCCE program was informed by physician feedback.
Treatment groups
330 Participants
are divided into 3 treatment groupsGroup A: Arm 1: Standard Communication ArmPlacebo comparator 1 intervention
Group B: Arm 2: Personalized Report CardExperimental treatment 1 intervention
Group C: Arm 3: Personalized Report Card + Bottom-Up FramingExperimental treatment 2 interventions
Trial outcomes
Primary outcomes
1
Physician Behavior: Rate of Engagement with Resources in First Email
Whether physicians click through to access the "PCCE Resources and Improvement Strategies", for which a link is provided via quarterly report card emails. The time frame is one week after the first email was sent, as a binary indicator.
Time frame
1 weekSecondary outcomes
1
Rate of Overall Resource Engagement
Click-through behavior to access the "PCCE Resources and Improvement Strategies" as a binary indicator will be examined at the physician-quarter level. In November 2023 when there was just one email communication, click-through behavior will be assessed for one week after this email was sent. Starting in February 2024, a reminder email was sent two weeks after the first email, so click-through behavior will be assessed during the time between the send date of the first quarterly email through one week after the send date of the reminder email, per quarter.
Time frame
12 months2
Domain-Specific and Aggregate PCCE Performance
Standardized z-scores of the metrics for each domain in the PCCE program will be averaged following the incentive program weights to measure domain-specific performance at the physician-quarter level. The investigators will analyze performance in each domain separately. Also, to analyze the effect of an intervention on aggregate performance, physician-quarter-domain level data will be analyzed in regressions weighted by the program domain weights for physicians' affiliation. This will be examined from January through September, 2024. If there is a significant effect, the investigators will explore whether the effect persists through June 2025. If there is no positive significant effect of an intervention, the investigators will examine the effect of the intervention on the "points" that physicians receive, since physicians may focus on meeting thresholds to earn points (rather than improving absolute performance).
Time frame
9 months3
Rate of Citizenship Behavior
Physician willingness in a survey to opt in to perform an organizational citizenship behavior, as a binary indicator for whether physicians opted in.
Time frame
2 weeks4
Physician Workplace Attitudes
Measured with 4 items about: 1) trust in UCLA Health leadership (scale measured from 1-7, with higher values indicating higher trust), 2) perceived leadership support (scale measured from 1-5, with higher values indicating higher support), job satisfaction (scale measured from 1-7, with higher values indicating more satisfaction), and burnout (scale measured from 1-5, with higher values indicating more burnout).
Time frame
12 monthsSponsors and contacts
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Source ClinicalTrials.gov