A study published today in the Journal of the American Medical Association finds that pay-for-performance may not performing quite as well in real life as some health policy wonks had predicted. The two-year study by researchers at the Harvard School of Public Health compared the use of pay-for-performance at physician practices affiliated with PacifiCare in California with practices in the Pacific Northwest which do not use incentive programs. Clinical quality scores for cervical cancer screening, mammography, and hemoglobin A1c testing showed only modest improvements in the group using incentives. Critics also noted that most of the bonus money went to doctors who were already top performers. Given that Medicare and many private plans are introducing pay-for-performance, expect this study to be much discussed.
- see this article from Forbes