Performance-driven incentive plans can help small practices turn routine metrics into meaningful growth. According to Alexandra Acabá Berrocal, DHA, FACMPE, MSW, aligning productivity and quality measures with accountability, these frameworks can motivate teams, improve retention, and support long-term practice success.

The following transcript has been edited for clarity.

In my course, “Sustainable Growth for Small Practices: Designing Performance-Driven Incentive Plans,” at the [American Academy of Ophthalmology 2026 Meeting], we went over the importance of designing performance plans that allow practices to grow and that can be tailored to specific practices.

Oftentimes, I work with small practices that don't really have a model to continue to grow, and this happened in my practice. So what I decided to do was to implement a performance-improvement program that would basically hold all the stakeholders in my practice accountable, including my staff and including my physicians.

Types of Performance Incentive Models

Productivity-Based Models 

• Strengths: Simple and directly related to revenue.
• Weaknesses: Can negatively impact quality and encourage over-booking and over-working, leading to team burnout.  
• Best for: High-volume (such as collections roles) and transactional roles.

Quality-Based Models

• Strengths: Emphasizes practice’s commitment to delivering high quality care. 
• Weaknesses: Encourages slower feedback and can feel subjective.
• Best for: Clinical and provider roles. 

Hybrid Models 

• Strengths: Provide a balance between the strengths and weaknesses of productivity and quality models.
• Weaknesses: More complex and requires full transparency and consistency in measurement. 
• Best for: Most small practices and smaller teams.

The course really provided all the attendees the opportunity to not only learn why metrics are important [but also] why we need to measure these in our practice consistently—which is something that my practice was already doing—and how to take it to the next level.

This session truly emphasized the different practical frameworks and real-world metrics that I currently use, and I provided a roadmap on how practices can build incentive plans that motivate teams, improve accountability, and support long-term growth. 

Doing this course was particularly interesting at this point in time, in which a lot of small practices are trying to grow, and so I think it's very important for all stakeholders to take from this course how just measuring metrics is not enough in today's health care landscape. It is also important to take those metrics to the next level and understand the different productivity- vs quality-based incentive models and how you can use them in a hybrid manner to also increase retention.

Particularly right now, when there's so much employee turnover, these models and this framework is truly a way in which small practices can take their metrics to the next level and be able to grow successfully.