Providing Insights that Contribute to Better Health Policy
Insurance Coverage & Costs Access to Care Quality & Care Delivery Health Care Markets Issue Briefs Data Bulletins Research Briefs Policy Analyses Community Reports Journal Articles Other Publications Surveys Site Visits Design and Methods Data Files
Health Plans Offer Financial Rewards for Higher Quality Care
Physicians and Hospitals Receptive but Wary of Tying Pay to Performance
FURTHER INFORMATION, CONTACT:
ASHINGTON, D.C.Health plans increasingly are dangling a carrothigher paymentsto get physicians and hospitals to improve patient care, according to a study released today by the Center for Studying Health System Change (HSC).
"Pay-for-performance initiatives are just getting off the ground in most communities, but they can provide a springboard for broader acceptance of tying physician and hospital payments to quality improvement," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded principally by The Robert Wood Johnson Foundation.
The studys findings are detailed in a new HSC Issue BriefPaying for Quality: Health Plans Try Carrots Instead of Sticks. The study is based on HSCs 2002-03 site visits to 12 nationally representative communities: Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey; Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y.
"Health plan-based quality incentive programs exist in seven of the 12 HSC communities, and most programs are sponsored by major health plansthose with large market share and, therefore, significant influence over providers," said HSC Research Analyst Bradley C. Strunk, coauthor of the study with Robert E. Hurley, Ph.D., an HSC consulting researcher from Virginia Commonwealth University.
Two landmark Institute of Medicine reportsTo Err Is Human in 1999 and Crossing the Quality Chasm in 2001drew attention to significant quality and patient-safety shortcomings in the American health care system. A key recommendation in Crossing the Quality Chasm was to align payment policies with quality improvement. Quality incentive programs across the HSC communities varied on three key design features: quality measurement, incentive payment structure and incentive size:
Interviews with plans, providers and purchasers suggest that plans have been the prime movers behind quality incentives in the 12 communities, and many of the programs focus on promoting the practice of evidence-based medicine. Other key study findings include:
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.