As the industry shifts toward rewarding quality and not quantity, healthcare leaders still wonder whether pay-for-performance (P4P) models will actually improve care and cut costs.
According to a four-year study of three New York City hospitals, quality-oriented programs can cut costs but won't affect patient outcomes. Researchers examined eight types of major operations and found "no significant difference" in complications and death rates after P4P models were implemented.
"The cornerstone of any pay-for-performance program has to be the continued delivery of excellent and quality care," lead investigator Dr. Faiz Y. Bhora, a general surgeon at St. Lukes-Roosevelt Hospital Center, said in a statement. "That's where we as physicians need to stay engaged with pay-for-performance programs, so that it's not just a financial program, but a quality program as well."
Despite such findings, other providers and payers continue to set up their own quality incentive programs, saving money and lives. For example, Highmark's 10-year-old P4P program has prevented more than 1,500 central line blood infection, as well as saved the local healthcare system between $11 million and $45 million during the past five years, reports the Pittsburgh Post-Gazette.
The program, which includes 81 hospitals, 6,300 physicians, and about 1,600 physician practices, also helped avoid nearly 351 cases of Methicillin-resistant Staphylococcus aureus during the past four years.
Meanwhile, nine hospitals of the North Shore-LIJ Health System yesterday received 68 awards for delivering high-quality care through a voluntary, national pay-for-performance project. The Centers for Medicare & Medicaid Services also gave North Shore-LIJ $906,955 in the past year (plus almost $3.7 million for the entire six-year demonstration project), suggesting that financial incentives to hospitals can improve patient care.
Earlier this year, WellPoint took a big step toward quality-oriented healthcare, tying quality metrics to annual payment increases for about 1,500 hospitals nationwide.
- read the ACS press release
- here's the North Shore-LIJ press release
- read the Pittsburgh Post-Gazette article