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Pioneering hospital pay-for-performance program falls short of its goals
Date:6/8/2011

Massachusetts' innovative use of "pay-for-performance" bonuses to try to reduce racial and ethnic disparities in the case of Medicaid patients has turned up no evidence of the problem at any of the state's 66 acute-care hospitals, according to a new study that raises questions about the effectiveness of the state's novel approach.

While the study, published in the June edition of Health Affairs (June 9, 2011), found that racial and ethnic inequities for disadvantaged patients may well exist, it also determined that the hospital "pay-for-performance" approach typically used to improve quality of care proved unsuited to the task of identifying health care disparities or their severity, at least in the pioneering first years of its use.

According to the study, "Massachusetts' racial and ethnic disparities legislation was based on the assumptions that there were racial and ethnic disparities in the treatment of patients within the state's hospitals and that every hospital's patient population was sufficiently diverse to make a statewide intervention sensible."

However, the researchers found, the clinical conditions tracked in the pay-for- performance program did not bring to light any significant racial and ethnic disparities in hospital care. In addition, the hospitals' patient population was not sufficiently diverse to allow the approach to succeed in its goals of finding and narrowing gaps in care among the disadvantaged, the study stated.

It was in 2006 that Massachusetts passed major legislation to expand health insurance coverage throughout the state. The law, which would influence the federal Affordable Care Act implemented in 2010, featured a large increase in the state's Medicaid payment rate for hospitals, and with that increase came greater accountability in the form of the pay-for-performance program. Under the data-driven program, hospitals that performed well on specified measurements were eligible to rec
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Contact: Robert Polner
robert.polner@nyu.edu
646-522-3046
New York University
Source:Eurekalert

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