Medicare P4P results show care improvements

The results are in on the latest round of Medicare's 266-hospital, three-year pay-for-performance test. And it appears that, initially, P4P incentives are doing what they're supposed to do--improve adherence to evidence-based care. For example, under the new program, managed by nonprofit hospital alliance Premier, it appears that more heart attack patients are getting aspirin when they come into the ED. The winner in the competition to date was Hackensack University Medical Center, which received a bonus of about $744,000 after coming in as top performer in all five areas measured. CMS officials expect to announce today that they're handing out a total of $8.7 million to 115 hospitals that came up as top performers on 30 quality measures.

However, as with P4P programs elsewhere, some hospitals are grumbling that the standards reward only the top hospitals, and are focused on offering more care rather than getting better results. Still, there was some obvious outcomes improvement across the board, with, among other benefits, the hospitals experiencing nearly 1,300 fewer deaths in treating heart attack patients.

To get more background on the P4P effort:
- read this piece from The New York Times

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