HOUSTON (Sept. 11, 2013) When health care pundits began to suggest that pay-for-performance would solve some of health care's woes, Dr. Laura Petersen, professor of medicine at Baylor College of Medicine and director of the Houston VA Health Services Research and Development Center of Excellence, had questions.
How do we know that it will solve those problems? she asked. How do we know whether or not it will create new problems? And how will we structure these payments? As a recognized expert in the area of health care services and quality, she set out to find the answers in a multi-year study involving 83 physicians and 42 other health care personnel in 12 different Veterans Affairs hospital-based outpatient clinics.
She and her colleagues found that modest monetary incentives to individual physicians resulted in a significant 8.36 percent increase in patients whose blood pressure was brought down to desired levels or who received an appropriate medical response when it was found that their blood pressure was uncontrolled. However, incentives to a whole health care team or to the physician plus health care team did not have a significant effect. There was virtually no change at all in the control group that received no incentives. A report on their work appears in the Journal of the American Medical Association.
"This is not a panacea for everything that is wrong in health care, but it can have a significant effect in improving care," said Petersen, who is also associate chief of staff for research at the Michael E. DeBakey VA Medical Center. "Pay for performance is attractive because it would be a system-wide plan that could be implemented on a wide scale. With this, we have demonstrated that you
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Baylor College of Medicine