Study Questions Effectiveness of Pay-for-Performance System
Despite the rapid adoption of pay-for-performance programs by health plans, the programs have failed to improve quality, according to a RAND study published in Health Affairs Tuesday, Reuters/Boston Globe reports. Researchers looked at a pay-for-performance program that started in 2003 and involves seven major California health plans and 225 physician groups that treat 6.2 million people.
Most of the medical groups surveyed in the study reported that the program's financial incentives -- about $1,500 to $2,000 annually per physician -- were not adequate enough to prompt change among physicians. Researchers suggested that financial incentives should increase by two to five times in order to see improvements in quality. The study did find that the program helped encourage adoption of health information technology, such as electronic health records.
A separate study in the Annals of Family Medicine, which included in-depth interviews of physicians in California and Britain, found that doctors believed pay-for-performance programs interfered with the doctor-patient relationship. The California physicians said that they resented the structure of the audit and payment systems, which sometimes affected care provision. The authors said such issues could be addressed by giving doctors more independence to implement the programs (Steenhuysen, Reuters/Boston Globe, 3/10).
An abstract of the RAND study is available online.
The Annals of Family Medicine study also is available online.
