• Robert Leverence, Richard Nuttall, Rachel Palmer, Mark Segal, Alicia Wood, Fay Yancey, Jonathon Shuster, Mark Brantly, and Robert Hromas.
• R. Leverence is professor and vice chair, Department of Medicine, and chief, Division of Hospital Medicine, College of Medicine, University of Florida Health, and director of utilization review, Shands Teaching Hospital, Gainesville, Florida.R. Nuttall is chief financial officer, School of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.R. Palmer is vice chair for administration, Department of Medicine, College of Medicine, University of Florida Health, Gainesville, Florida.M. Segal is professor and chief, Division of Nephrology, Hypertension, and Renal Transplantation, and co-vice chair for research, Department of Medicine, College of Medicine, University of Florida Health, Gainesville, Florida.A. Wood is chief financial officer, Department of Medicine, College of Medicine, University of Florida Health, Gainesville, Florida.F. Yancey is chief operating officer, Department of Medicine, College of Medicine, University of Florida Health, Gainesville, Florida.J. Shuster is professor, Departments of Health Outcomes and Policy, and Biostatistics, Epidemiology and Research Design Program, Clinical and Translational Science Institute, and biostatistician, College of Medicine, University of Florida Health, Gainesville, Florida.M. Brantly is professor and chief, Division of Pulmonary, Sleep and Critical Care Medicine, and co-vice chair for research, Department of Medicine, College of Medicine, University of Florida Health, Gainesville, Florida.R. Hromas is professor and chair, Department of Medicine, College of Medicine, University of Florida Health, Gainesville, Florida.
• Acad Med. 2017 Aug 1; 92 (8): 1133-1137.

ProblemAcademic physician reimbursement has moved to productivity-based compensation plans. To be sustainable, such plans must be self-funding. Additionally, unless research and education are appropriately valued, faculty involved in these efforts will become disillusioned, yet revenue generation in these activities is less robust than for clinical care activities.ApproachFaculty at the Department of Medicine, University of Florida Health, elected a committee of junior and senior faculty and division chiefs to restructure the compensation plan in fiscal year (FY) 2011. This committee was charged with designing a new compensation plan based on seven principles of organizational philosophy: equity, compensation coupled to productivity, authority aligned with responsibility, respect for all academic missions, transparency, professionalism, and self-funding in each academic mission.OutcomesThe new compensation plan was implemented in FY2013. A survey administered at the end of FY2015 showed that 61% (76/125) of faculty were more satisfied with this plan than the previous plan. Since the year before implementation, clinical relative value units per faculty increased 7% (from 3,458 in FY2012 to 3,704 in FY2015, P < .002), incentives paid per faculty increased 250% (from $3,191 in FY2012 to $11,153 in FY2015, P ≤ .001), and publications per faculty increased 15% (from 2.6 in FY2012 to 3.0 in FY2015, P < .001). Grant submissions, external funding, and teaching hours also increased per faculty but did not reach statistical significance.Next StepsAn important next step will be to incorporate quality metrics into the compensation plan, without affecting costs or throughput.

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