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

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-
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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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