Study: Performance-based pay shows promise in pediatric ACO settings

By Matt Kuhrt

Offering financial incentives to providers in a pediatric accountable care organization (ACO) led to improved outcomes, according to a new study in JAMA Pediatrics. What's more, data suggest additional interventions may further enhance quality improvements.

Much of the shift to value-based payment models has been premised on the idea that improving patient outcomes and reducing costs throughout the medical system require a rethinking of the incentive structure embedded in the fee-for-service model.

Although healthcare organizations such as ACOs are in a position to innovate along these lines, the friction between doctors and administrations regarding the best way to increase efficiency calls into question the ultimate efficacy of financial incentives, as FiercePracticeManagement has previously reported.

Looking into the numbers of the JAMA study, while financial incentives yielded significantly better quality measures, "hospital-employed primary care physicians who were targeted with non-incentive-based improvement efforts achieved greater performance improvements" compared to community physicians who only received performance-based financial incentives, according to an article in Managed Healthcare Executive. Therefore, the study not only "found that a physician pay-for-performance program accelerated improvement rates in quality measures," but also that, "close quality improvement support of the practice is even more effective," said the study's author, Sean Gleeson, M.D.

In that light, the results serve as a reminder that, while effective, financial incentives are only one tool in the toolbox, further underscoring the value of a coordinated approach to care in a value-based system.

To learn more:
- see the study results in JAMA Pediatrics
- read the article in Managed Healthcare Executive

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