Field of Work: Using financial incentives to improve the quality of health care.
Problem Synopsis: According to a 1999 report from the Institute of Medicine, preventable medical errors resulted in the death of an estimated 44,000 to 98,000 hospital patients a year. Americans were getting poor quality care, the wrong care or care that could hurt them. The IOM report urged that the health care payment system be redesigned to reward providers for implementing improvements in their care processes.
Synopsis of the Work: Rewarding Results: Aligning Incentives with High-Quality Health Care (January 2002 to March 2009), funded by the Robert Wood Johnson Foundation and the California HealthCare Foundation, tested the use of financial incentives to improve the quality of health care. The program supported seven projects across the nation that implemented systems designed to measure the performance of health care providers and adjust their compensation based on performance scores—a strategy commonly termed pay for performance.
The projects, their evaluations and related educational materials informed the health care sector about pay-for-performance designs and processes—those that were effective as well as those requiring refinement.
- Together the seven demonstrations paid out tens of millions of dollars in provider incentives and instituted performance reports and other nonfinancial mechanisms to help physicians gauge and improve the quality of their care.
Six of the seven projects continued after program funding ended.
According to the national program office, the key lessons learned:
- Financial incentives motivate change, but they need to be large enough to make a difference.
- Nonfinancial incentives, such as additional staffing, infrastructure and technology, also can make a difference.
- Engaging physicians is a critical activity.
- There is no clear picture yet of return on investment (ROI).
- Public reporting is a strong catalyst for providers to improve care.
- Providers need frequent, clear and actionable feedback on their performance.
- Providers need to be better educated about pay for performance.
- Data integrity is important.
- Experience with managed care appears to be a factor in the success of pay for performance.
- Pay for performance is not a magic bullet, but can be a useful tool.
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
RWJF examines the types of competitive foods - foods and beverages schools offer outside of meal programs - available in our nation's school...
Progress and lessons learned from two programs that seek to advance the impact digital games can have on health.
Joint Commission Resources in Oak Brook Ill., oversaw development and testing of an online course and support materials to improve communica...
The rapid rise of antibiotic resistance can be tracked using ResistanceMap, an online tool that visually highlights regions of the country w...
Report examines, compares and contrasts Massachusetts and Utah health insurance exchanges.
Report examines issues states will face as they integrate Medicaid into the exchange.
This poll shows most Americans believe the quality of U.S. health care is average at best. More than half of American adults surveyed barely...
Want to improve health? Start with where we live, work, learn and play.
Health care reform may create incentives to spur the growth in HDHPs and CDHPs, a move that might help hold costs down?at least for a time.
The authors suggest repairing the health care system by realigning provider incentives, increasing the availability of information with whic...
While the ACA is aimed primarily at improving individual health by increasing access to health insurance, it also contains a number of provi...