Impact of Pay-for-Performance Contracts and Network Registry on Diabetes and Asthma HEDIS® Measures in an Integrated Delivery Network

Levin-Scherz, Jeffrey; Devita, Nicole G; Timbie, Justin W.

doi:10.1177/1077558705284057

Cited by 61 publications

(63 citation statements)

References 8 publications

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“…These studies often suffer from poor study design: some of them only employed simple before-after mean comparison or trend comparison (Levin-Scherz et al 2006;Young et al 2007;Cutler et al 2007;Pearson et al 2008); others do not provide any comparison group as the counterfactuals (Amundson et al 2003;Mandel and Kotagal 2007;Chung et al 2010;Boland et al 2010;Lester et al 2010;Coleman et al 2007). Some of the programs were targeted at health plans or clinics instead of individual physicians, so the lack of individuallevel data makes it difficult to draw inference on physician responses to P4P incentives (FeltLisk et al 2007;Gavagan et al 2010).…”

Section: Empirical Evidence On Physician Response To P4pmentioning

confidence: 99%

Physician Response to Pay-for-Performance: Evidence from a Natural Experiment

Hurley

DeCicca

et al. 2011

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Explicit financial incentives, especially pay-for-performance (P4P) incentives, have been extensively employed in recent years by health plans and governments in an attempt to improve the quality of health care services. This study exploits a natural experiment in the province of Ontario, Canada to identify empirically the impact of pay-for-performance (P4P) incentives on the provision of targeted primary care services, and whether physicians' responses differ by age, practice size and baseline compliance level. We use an administrative data source which covers the full population of the province of Ontario and nearly all the services provided by practicing primary care physicians in Ontario. With an individual-level data set of physicians, we employ a difference-in-differences approach that controls for both "selection on observables" and "selection on unobservables" that may cause estimation bias in the identification. We also implemented a set of robustness checks to control for confounding from the other contemporary interventions of the primary care reform in Ontario. The results indicate that, while all responses are of modest size, physicians responded to some of the financial incentives but not the others. The differential responses appear related to the cost of responding and the strength of the evidence linking a service with quality. Overall, the results provide a cautionary message regarding the effectiveness of pay-for-performance schemes for increasing quality of care.

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Section: Empirical Evidence On Physician Response To P4pmentioning

confidence: 99%

Physician Response to Pay-for-Performance: Evidence from a Natural Experiment

Hurley

DeCicca

et al. 2011

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“…[1][2][3][4][5][6] The care of patients with multiple clinical conditions has to balance the clinical benefits of achieving disease-based quality standards with addressing competing patient priorities that reflect their clinical illnesses. [7][8][9] Methods to measure quality of care in patients with multiple clinical conditions have been poorly developed because of the "one size fits all" principle underlying current quality measurement approaches.…”

Section: Introductionmentioning

confidence: 99%

Measuring Quality of Care in Patients With Multiple Clinical Conditions: Summary of a Conference Conducted by the Society of General Internal Medicine

et al. 2007

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“…5 In a large, heterogenous integrated delivery network, P4P contracts for physicians led to significant improvement in quality metrics relating to care of asthmatic and diabetic patients. 16 A program involving 45 000 physicians in California estimated that, in the first full year of P4P, 210 000 more patients received cervical and breast cancer screening, immunisations or diabetes tests. 17 While the debate around efficacy continues, several commentators have raised concerns about unintended, adverse consequences of P4P and whether such a strategy can achieve sustained across-the-board improvements in care.…”

mentioning

confidence: 99%

Pay for performance programs in Australia: a need for guiding principles

Scott¹

2008

Aust. Health Review

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Pay-for-performance (P4P) programs which reward clinical providers with incentive payments based on one or more measures of quality of care are now common in the United States and the United Kingdom and it is likely they will attract increasing interest in Australia. However, empirical evidence demonstrating effectiveness of such programs is limited and many existing programs have not had rigorous outcome evaluation. To maximise success, future P4P programs should incorporate the lessons and insights obtained from previous experience. Based on a review of published trials, program evaluations and position statements, the following principles that may guide future program design and implementation were synthesised: 1) formulate a rationale and a business case for P4P; 2) use established evidencebased performance measures; 3) use rigorous and verifiable methods of data collection and analysis; 4) define performance targets using absolute and relative thresholds; 5) use rewards that are sufficient, equitable and transparent; 6) address appropriateness of provider responses and avoid perverse incentives; 7) implement communication and feedback strategies; 8) use existing organisational structures to implement P4P programs; 9) attribute credit for performance to participants in ways that foster population-based perspectives; and 10) invest in outcomes and health service research. Recommendations flowing from these principles relevant to Australian

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Impact of Pay-for-Performance Contracts and Network Registry on Diabetes and Asthma HEDIS® Measures in an Integrated Delivery Network

Cited by 61 publications

References 8 publications

Physician Response to Pay-for-Performance: Evidence from a Natural Experiment

Physician Response to Pay-for-Performance: Evidence from a Natural Experiment

Measuring Quality of Care in Patients With Multiple Clinical Conditions: Summary of a Conference Conducted by the Society of General Internal Medicine

Pay for performance programs in Australia: a need for guiding principles

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