Navigation Links
Pay-for-performance does not improve patient health
Date:1/25/2011

BOSTON, Mass. (Jan. 26, 2011)As news outlets throughout Europe and the U.S. report on the plummeting health of Western adults and children, there is no shortage of culprits. One villain often bandied about is the "fee for service" system of incentives for physicians. Clearly, if doctors are financially rewarded for simply performing more procedures, costs will soar at the expense of patient health.

Enter Pay-for-Performance, an emerging movement in which physicians are rewarded not for what they do, but for quality of care and patient outcomes. Under such a system, economic logic dictates that patients should theoretically show marked improvements when doctors' incentives shift from procedure to patient.

This new approach was implemented in the United Kingdom in 2004 in a program termed "Quality and Outcomes Framework." But whether or not such an approach has actually improved patient health remains an open question.

A new study published January 26 in BMJ presents the strongest evidence yet that Pay-for-Performance does not offer any benefit to patients with hypertension, despite the enormous administrative costs required to maintain such a system.

"No matter how we looked at the numbers, the evidence was unmistakable; by no measure did pay-for-performance benefit patients with hypertension," says lead author Brian Serumaga, formerly of Harvard Medical School/Harvard Pilgrim Health Care Institute, but now at University of Nottingham Medical School.

Working closely with researchers at Harvard, Nottingham, and the University of Alberta in Canada, Serumaga and his colleagues focused on how Pay-for-Performance might affect outcomes in patients with hypertension, a condition where other interventions such as patient education have shown to be very effective.

Analyzing data from the UK's Health Improvement Network, a large database of primary care records from 358 UK general practices, the international research team identified 470,725 patients diagnosed with hypertension between January 2000 and August 2007, spanning four years prior, and three years after, Pay-for-Performance was implemented.

The researchers looked at various measures including blood pressures over time, rates of blood pressure monitoring, and hypertension outcomes as well as illnesses.

Analysis showed that even after allowing for a number of variations, there was no identifiable impact on the cumulative incidence of stroke, heart attacks, renal failure, heart failure or mortality in both patients who had started treatment before 2001 and patients whose treatment had started close to the implementation of Pay-for-Performance.

"Governments and private insurers throughout the world are likely wasting many billions on policies that assume that all you have to do is pay doctors to improve quality of medical care," says senior author Stephen Soumerai, professor in the Department of Population Medicine at Harvard Medical School and Harvard Pilgrim Health Care Institute. "Based on our study of almost 500,000 patients over seven years, that assumption is questionable at best."

According to Anthony Avery, also of University of Nottingham Medical School, "Doctor performance is based on many factors besides money that were not addressed in this program: patient behavior, continuing MD training, shared responsibility and teamwork with pharmacists, nurses and other health professionals. These are factors that reach far beyond simple monetary incentives."

"Policymakers sometimes legislate large and expensive policies based on their beliefs without the requisite hard evidence," says Soumerai. "Policy makers in the U.S. and in Canada who are attempting to enact such programs need to think hard about other more effective approaches."


'/>"/>

Contact: David Cameron
617-432-0441
Harvard Medical School
Source:Eurekalert

Related medicine news :

1. Pay-for-performance programs show positive impact on low-performing physicians
2. Panel: Properly designed pay-for-performance models can support medical professionalism
3. ATS endorses pay-for-performance for pulmonary, critical care and sleep medicine
4. Pay-for-performance programs may worsen medical disparities, study finds
5. Pay-for-performance for hospitals
6. Pay-for-performance programs improve radiology report turnaround times, study suggests
7. A New Website Series Improves Appearance and Health City by City
8. CustomerCentric Selling and Kadient Announce Joint Event in Boston to Launch Strategic Partnership for Sales Enablement and Improvement
9. Exercise Success for People Over 50: Reports of Improved Fitness, Circulation and Balance
10. NationalCreditReport.com Reminds Consumers of Ways to Improve Credit Report and Score in 2010
11. Medical Transcription Services and EHR Provider MxSecure Launches New Enhanced Website with Goal of Improved Physician Productivity
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... , ... The Visiting Nurse Association (VNA) of Somerset Hills is proud to ... unique items from across the nation, this holiday-themed event will raise funds and awareness ... VNA. The boutique will be open Saturday, November 4 (10:00 a.m. – 5:00 ...
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... ... will be giving viewers the lowdown on sciatica in a new episode of ... that focuses on current events and innovation and investigates each subject in-depth with ...
(Date:10/12/2017)... WILMINGTON, Del. (PRWEB) , ... October 12, 2017 ... ... technology and advisory services for healthcare compliance program management, will showcase a range ... and National Association for Assisted Living (NCAL) Convention and Expo to be held ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... IsoComforter, Inc. ... products, announced today the introduction of an innovative new design of the shoulder pad. ... so you get maximum comfort while controlling your pain while using cold therapy. By ...
(Date:10/12/2017)... ... October 12, 2017 , ... Dr. Parsa ... contributed a medical article to the newly revamped Cosmetic Town journal ... the hair transplant procedure known as Follicular Unit Extraction (FUE). , ...
Breaking Medicine News(10 mins):
(Date:10/4/2017)... Korea , Oct. 4, 2017  South Korean-based ... next-generation CPR training aide "cprCUBE" on Kickstarter. The device ... compression during cardiac arrests with better efficiency compared to ... also offers real-time feedback on efficacy of the compression ... crowdfunding campaign has a goal to raise $5,000. ...
(Date:10/2/2017)... , Oct. 2, 2017  AllianceRx Walgreens Prime, the ... by Walgreens and pharmacy benefit manager Prime Therapeutics LLC ... brand, which included the unveiling of new signage at ... as well as at a few other company-owned facilities ... brand to patients, some of whom will begin to ...
(Date:9/27/2017)... -- Commended for their devotion to personalized service, SMP Pharmacy Solutions ... in the South Florida Business Journal,s 50 Fastest-Growing Companies, and ... the national specialty pharmacy has found its niche.  To that ... be honored by SFBJ as the 2017 Power Leader in ... receive his award in October, Bardisa said of the three ...
Breaking Medicine Technology: