Study: P4P may have little impact on quality

Of late, health plans and employers have been rolling out pay-for-performance programs aggressively on the assumption that such programs offer a helpful method for improving healthcare quality. In fact, more than 150 programs built around rewarding evidence-based care exist, according to research by American Medical News. However, according to one piece of research, some of these efforts might be wasted. That, at least, is the conclusion drawn by a new analysis of quality incentives published in Health Affairs.

The study, which compared 81 Massachusetts physician groups in incentive programs with 73 that were not, found that while overall performance on preventive measures like breast cancer screening and well-child visits improved 73 percent, it was impossible to distinguish one group of physicians from the other statistically. In other words, all physicians' quality improved, whether or not they were jockeying for a bonus.

These results don't necessarily suggest that all P4P programs don't work, the study's authors stressed. The impact of P4P initiatives can vary dramatically depending on how the program is implemented, they noted. Also, American P4P programs tend to offer rewards in the range of 5 percent to 9 percent of payments, which may not be enough to motivate doctors. (In contrast, British doctors can more than double their income by meeting quality targets.)

To learn more about this study:
- read this AMNews piece

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