Research reported in the New England Journal of Medicine suggests that a hospital pay-for-performance program in part of England may have led to reduced mortality for three conditions, with pneumonia showing a statistically significant decrease.
In yet another piece evaluating the effectiveness to-date of pay-for-performance programs, Health Affairs carries a review of research on the topic, finding that results are mixed. Some seem to have improved quality, but others did not and providers caring for poorer and sicker patients may be disadvantaged.
More research, this time from the Journal of the American Medical Association, to suggest that another quality improvement technique, this time public reporting of outcomes, does not achieve the intended goals. In regard to heart attack patients receiving PCI, public reporting seems to lead to lower rates of the procedure and no change in mortality outcomes.
Research reported in the New England Journal of Medicine reveals that the Centers for Medicare and Medicaid Services program of not paying for certain hospital acquired infections is not working, to put it mildly. The program seems to have had absolutely no impact on the targeted infection rates.
Are financial incentives for providers a good thing? A review in the British Medical Journal examines when financial incentives can be helpful in improving care and when they might actually lead to worse outcomes. The authors created a checklist designed to provide easy guidance on design and implementation of pay for performance type programs.
Pay-for-performance programs have enough problems demonstrating that they actually work to improve outcomes and now the Government Accounting Office has identified another potential problem for these initiatives–the federal fraud and abuse regulations.
Our latest Potpourri features the comparative cost of cancer care in the US and elsewhere, the effect of genomics on spending, international practice guidelines, state Medicaid waivers, unintended consequences from patient satisfaction efforts and county health rankings.
In an era of multiple programs measuring outcomes and costs by provider and by disease or condition, the importance of consistent coding in the data used to do the measurement cannot be overstated, yet it appears that coding, and coding changes may have a substantial influence in results, according to a new JAMA study.
Makes sense that paying for better delivery of quality care would improve outcomes, but the research so far doesn’t support that notion. The latest evidence is a study in the New England Journal of Medicine on the patient outcomes effects of the Medicare Hospital Quality Incentive Demonstration.
Its March and spring nears; our Potpourri blooms with nuggets of health care information, including comparative regulation of medical devices in the US and Europe, do physicians always truthful with patients, CMS’ oversight of home health care agencies, the validity of a CMS’ measure of ER scanning, and patient-centered care.
Patient satisfaction surveys and scores are a large component in most pay-for-reporting, pay-for-performance and value-based purchasing programs, on the theory that patient satisfaction is linked to quality. A new study published in the Archives of Internal Medicine undercuts this theory.