Purpose. Few salary incentive plans for academic health center faculty funded primarily by research grants exist, and hence the optimal structure for such plans is uncertain. The author examined the impact of incentives and the optimal structure for a salary incentive plan for a group of research faculty at the Yale University School of Medicine (Yale). Method. A three-part instrument was delivered to a convenience sample of 40 faculty to determine the impact of their risk aversion on two salary plans. Utility theory was used to quantify their preferences for the Expense Model (salary bonuses are paid from direct costs of the research award) and the No Expense Model (salary increases are funded from another source). Outcomes were projected for both models over a range of funding probabilities. Results. In all, 27 faculty responded. On average, Yale faculty had risk-averse (and therefore unfavorable) attitudes towards the Expense Model, with substantial variability in response depending on rank. In contrast, Yale faculty had more homogeneous risk seeking (and therefore favorable) responses to the No Expense Model. Cost recoveries were greatest for the No Expense Model. Conclusions. Utility modeling demonstrated that the optimal incentive payment for the Expense Model is substantially greater than for the No Expense Model, and increases as the probability of obtaining funding with diligent effort declines. For purposes of both equity and efficacy, the No Expense Model appears preferable to the Expense Model. Modeling can be used to determine optimal incentive-plans and bonus-payment magnitudes for research faculty.
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