A paper from the National Bureau of Economic Research finds that quality report cards may be helpful in sorting skilled nursing facilities.
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A meta-review of pay-for-performance programs concludes that they have done little to nothing to improve health outcomes.
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A brief from the Agency for Healthcare Research & Quality presents useful information on how to design good physician feedback reports.
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A review of CMS's programs to encourage its version of quality of hospital care for Medicare beneficiaries is published in Health Affairs.
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A new study of pay-for-performance programs finds modest results overall, but better quality improvement for the initially worst-performing physicians.
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A study in Medical Care finds that for small community medical practices, providing incentives for improvement on certain quality measures, coupled with technical assistance, did lead to significant increases in performance on those measures, but also led to lower performance on other, unincented, quality measures. This demonstrates the oft-feared unintended consequence of pay-for-performance, it diverts attention from overall care quality.
http://journals.lww.com/lww-medicalcare/Abstract/2014/09000/The_Intended_and_Unintended_Consequences_of.10.aspx?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=13960954&_hsenc=p2ANqtz-8R-IQTu4G4PLgBsFZRz2zY9bj-XZNJ8Wd95njtcu8H5S1Qco5YHgwwm6awrbB4305uqpBcYAlr2eM-i7WM3M-chkydLQ&_hsmi=13960954Research published in the New England Journal of Medicine finds that the hospital pay-for-performance program adopted in England did not lead to sustained improvement in mortality rates.
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The United States is not the only country experimenting with pay-for-performance. England has had a large program for physicians for a decade and a New England Journal of Medicine commentary…
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A draft report from a panel established by the National Quality Forum finds that current performance measures penalize providers which serve large numbers of low-income patients for factors beyond the providers control.
http://www.nytimes.com/2014/04/28/us/politics/health-laws-pay-policy-is-skewed-panel-finds.html?&_r=1&utm_source=H2RMinutes+PCMH-ACO+May+6%2C+2014&utm_campaign=PCMH-ACO+mins+5%2F6%2F14&utm_medium=emailWith the proliferation of quality measures, a timely research piece in Health Affairs suggests that out of 13 common AHRQ indications, 7 account for 93% of the total benefits of compliance with the measures. The number of measures could be cut back on without affecting quality and lowering compliance costs and confusion.
http://content.healthaffairs.org/content/33/1/132.abstractA perspective in the New England Journal of Medicine critiques the application of Medicare value-based purchasing to physicians, pointing out that doctors have not accepted the system or the specific quality measures and participation is likely to be very limited until a better and less expensive system is implemented.
http://www.nejm.org/doi/full/10.1056/NEJMp1312287Research published in the Journal of the American Medical Association examines the effects of pay-for-performance incentives on quality of care in smaller physician offices that use EHRs.
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Quality measurement and incentive programs have become the norm but a new Report from the Urban Institute points out serious defects and issues with the design and execution of most…
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While we often focus our attention on the health care problems of the developed world, lower income countries have bigger issues, many of which are being addressed with the same…
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Thanks be given for our last Potpourri before Thanksgiving, a table spread with delectable bites of information on hospital readmissions and quality measure performance, health plan enrollment growth, health price…
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About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.
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