Navigation Links
Medical 'pay for performance' programs help improve care -- but not always, study finds
Date:11/23/2009

Like everybody, health care professionals enjoy a pay raise for a job well done. But in some instances, financial incentives for health care performance may actually backfire.

A new UCLA study shows that patient-care performance ratings for 25 medical groups across California improved significantly following the launch of a statewide pay-for-performance program in 2004 but not when incentives focused on doctors' productivity.

Reporting in the December edition of the Journal of General Internal Medicine, Hector P. Rodriguez, assistant professor in the department of health services at the UCLA School of Public Health, and colleagues found evidence that certain kinds of financial incentives for the purpose of improving patient care, in combination with public reporting of medical group performance ratings, have a positive effect on patient care experiences. However, they also found that some types of incentives may have a negative overall impact on how patients experienced their care.

The researchers analyzed how medical group performance ratings changed over time and found that ratings in specific measures representing three broad categories physician communication, care coordination and office-staff interactions improved substantially during the period after the start of the Integrated Healthcare Association's (IHA) pay-for-performance program. Incentives for addressing the quality of patient-clinician interaction and the overall experience of patient care tended to result in improved performance in those three areas, especially when the additional funds were used broadly by medical groups to positively reinforce a patient-centered work culture.

However, the greatest improvements were seen within those groups which placed less emphasis on physician productivity and greater emphasis on clinical quality and patient experience. And within groups where financial incentives were paid directly to physicians rather than being used more broadly the researchers found that placing too much emphasis on physician productivity actually had a negative impact on the experiences patients had when visiting their primary care doctor.

"As the Obama administration and Congress continue to grapple with health care reform, these findings provide timely information about the kinds of things medical groups can do and can avoid doing with financial incentives in order to improve the quality of patient health care experiences," said Rodriguez, the lead author of the study.

For the study, researchers looked at information collected from 124,021 patients of 1,444 primary care physicians at 25 California medical groups between 2003 and 2006 and conducted interviews with group medical directors to determine how financial incentives were used. All 25 groups, which represent six insurers, were awarded financial incentives for achievements in the broad categories of clinical care processes, patient care experiences and office-based information systems, in accordance with the IHA program, which was launched in 2004 with the goal of improving health care quality in California.

Medical groups were free to use the additional funds in various ways, with some groups paying incentives directly to physicians, and others using the incentives more broadly, with a focus on organizational priorities. The groups also participated in a public reporting program in which ratings in two of the three broad categories were released annually to the public in the form of a "health care report card" comparing the performance of the medical groups and insurers to one another.

"The current House bill being debated includes the establishment of a Center for Quality Improvement to identify and implement the best practices in the delivery of care," Rodriguez said. "Our study results suggest that the nature of financial incentives can affect the provision of patient-centered care. Therefore, quality improvement and reimbursement reform efforts should integrate patient-reported experiences of care as a central metric for evaluating reform effects."


'/>"/>

Contact: Sarah Anderson
sanderson@ph.ucla.edu
310-267-0440
University of California - Los Angeles
Source:Eurekalert

Related medicine news :

1. MSU engineering team designs innovative medical device
2. ATS Medical to Present at the 2007 Thomas Weisel Partners Healthcare Conference
3. Providence St. Joseph Medical Center, Caregivers Reach Agreement on a Union Contract
4. Owner and Operator of Florida Durable Medical Equipment Company Convicted of Medicare Fraud
5. Father and Daughter From Tanzania Receive Their First Medical Examination in Newport Beach
6. Doctors and medical ethicist discuss whether doctors should participate in capital punishment
7. Preparation for Natural Disasters Critical for People With Diabetes, Chronic Medical Conditions
8. Doctors and Medical Ethicist Discuss Whether Doctors Should Participate in Capital Punishment
9. Symmetry Medical Completes Acquisition Of Specialty Surgical Instruments
10. Milestone Scientific Announces Successful Completion of its Collaboration Agreement With Carticept Medical
11. FDA Seeks to Regulate Complementary and Alternative Medicine; Products Such as Vegetable Juice Could Be Restricted for Medical Use
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/2/2016)... ... May 02, 2016 , ... Pregnancy Awareness Month offers a great time ... , “If you are ready to have a baby, it’s best to get ... Journal Babies is your Personal Conception & Pregnancy Organizer, written for women who plan ...
(Date:5/2/2016)... ... May 02, 2016 , ... Consultative health ... and GM Jim Callandrillo and Duane Reed, VP of business development of AJMC ... Intelligence and Research Group (PBIRG) General Meeting from May 15-17 at the ...
(Date:5/2/2016)... (PRWEB) , ... May 02, 2016 , ... For many ... performance artist Curt Walter has developed it into a science. , Using the ... Walter achieve subtly differentiated shades that add depth and meaning to his works. What’s ...
(Date:5/2/2016)... ... May 02, 2016 , ... ... today announced the opening of Twin Lakes Recovery Center. Located east of ... in the state. The residential facility is set on 34 acres of ...
(Date:5/1/2016)... ... May 02, 2016 , ... ... 1968 Jimi Hendrix Merriweather Post Pavilion in Columbia, Maryland concert posters. Dail Beeghley ... The concert was held on August 16. According to Hawley, “The Pavilion was ...
Breaking Medicine News(10 mins):
(Date:5/2/2016)... 2, 2016  While nearly three-quarters of Americans (71%) ... on their health, only about half report taking any ... results of a new survey announced today by Hologic ... of National Osteoporosis Month, Hologic is raising awareness of ... 56 million Americans. Osteoporosis is a disease ...
(Date:4/29/2016)... , April 29, 2016  In the ... projected to shift from systems dependent on CRTs monitors ... types of modality CRT Medical monitors and will ... are a host of foreseeable benefits to this ... will existing modalities have to be replaced in ...
(Date:4/29/2016)... April 29, 2016 ... Financier Sanofi, leader mondial ... ses résultats pour le premier trimestre ... Jérôme Contamine, commente les résultats du ... perspectives pour le reste de l,année. ...
Breaking Medicine Technology: