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

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