<![CDATA[Academic hospitals integrate clinical care, education, research, and innovation; however, conventional remuneration systems often prioritize clinical productivity while undervaluing academic contributions. This study aimed to map the existing evidence on remuneration models and propose an integrated framework aligning professional contributions with institutional value creation. A scoping review was conducted using PubMed to identify English-language publications from 2010 through August 2026, supplemented by reference list screening and targeted source verification. Records were screened using Rayyan, relevant data were extracted into a structured matrix, and findings were synthesized thematically in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Of the 142 records identified, 29 studies published between 2008 and 2026 were included. Four thematic domains emerged: academic remuneration, hybrid gainsharing, value-based payment, and organizational performance. Existing remuneration models addressed educational contributions, efficiency gains, quality accountability, and institutional sustainability separately, without comprehensively integrating these dimensions across the academic hospital value chain. The proposed framework incorporated fixed remuneration, individual clinical and academic performance incentives, team-based gainsharing, and organization-wide gainsharing, supported by safeguards for healthcare quality, patient safety, equity, academic responsibilities, financial affordability, and institutional sustainability. These findings suggested that multidimensional incentive structures could strengthen alignment between professional performance and institutional missions while reducing excessive dependence on clinical productivity metrics. The proposed framework provided a conceptual foundation for remuneration reform in Indonesian academic hospitals; however, stakeholder consultation, empirical validation, and financial simulations were necessary before its practical implementation.]]>
