Featured Research

from universities, journals, and other organizations

Pioneering hospital pay-for-performance program falls short of its goals, study finds

Date:
June 9, 2011
Source:
New York University
Summary:
Massachusetts' innovative use of "pay-for-performance" bonuses to try to reduce racial and ethnic disparities in the case of Medicaid patients has turned up no evidence of the problem at any of the state's 66 acute-care hospitals, according to a new study that raises questions about the effectiveness of the state's novel approach.

Massachusetts' innovative use of "pay-for-performance" bonuses to try to reduce racial and ethnic disparities in the case of Medicaid patients has turned up no evidence of the problem at any of the state's 66 acute-care hospitals, according to a new study that raises questions about the effectiveness of the state's novel approach.

While the study, published in the June edition of Health Affairs (June 9, 2011), found that racial and ethnic inequities for disadvantaged patients may well exist, it also determined that the hospital "pay-for-performance" approach -- typically used to improve quality of care -- proved unsuited to the task of identifying health care disparities or their severity, at least in the pioneering first years of its use.

According to the study, "Massachusetts' racial and ethnic disparities legislation was based on the assumptions that there were racial and ethnic disparities in the treatment of patients within the state's hospitals and that every hospital's patient population was sufficiently diverse to make a statewide intervention sensible."

However, the researchers found, the clinical conditions tracked in the pay-for- performance program did not bring to light any significant racial and ethnic disparities in hospital care. In addition, the hospitals' patient population was not sufficiently diverse to allow the approach to succeed in its goals of finding and narrowing gaps in care among the disadvantaged, the study stated.

It was in 2006 that Massachusetts passed major legislation to expand health insurance coverage throughout the state. The law, which would influence the federal Affordable Care Act implemented in 2010, featured a large increase in the state's Medicaid payment rate for hospitals, and with that increase came greater accountability in the form of the pay-for-performance program. Under the data-driven program, hospitals that performed well on specified measurements were eligible to receive substantial bonuses.

The use of "pay for performance" for the purpose of identifying and reducing racial and ethnic disparities in the care of Medicaid patients within hospitals marked a new approach for states. After the innovation was introduced in 2008, it became a subject of national interest.

This study of Massachusetts' use of pay-for-performance to reduce racial and ethnic inequities in hospital care was authored by Dr. Jan Blustein, professor of health policy and medicine at the Robert F. Wagner Graduate School of Public Service at New York University, along with Joel S. Weissman of Mongan Institute for Health Policy at Massachusetts General Hospital and Harvard Medical School; Andrew M. Ryan, assistant professor of public health at Weill Cornell Medical College; Tim Doran, clinical research fellow in public health at the School of Health Sciences at the University of Manchester, England; and Roman Hasnain-Wynia, director, Center for Healthcare Equity, and associate research professor at the Feinberg School of Medicine at Northwestern University.

While no signs of racial or ethnic disparities were detected by the researchers, they noted the program is in its early years, and over time, policymakers may be able to more effectively measure and address disparities.

Even so, it's also possible that time will show that hospital pay-for-performance may be an inadequate tool for reducing health care disparities, the researchers wrote. A more effective way to reduce racial and ethnic inequities may be to focus on hospitals that heavily serve minority populations, or to attend to barriers to health and health care access that are rooted in factors "beyond hospital walls" over which hospitals have little direct influence, the authors suggested.


Story Source:

The above story is based on materials provided by New York University. Note: Materials may be edited for content and length.


Journal Reference:

  1. J. Blustein, J. S. Weissman, A. M. Ryan, T. Doran, R. Hasnain-Wynia. Analysis Raises Questions On Whether Pay-For-Performance In Medicaid Can Efficiently Reduce Racial And Ethnic Disparities. Health Affairs, 2011; 30 (6): 1165 DOI: 10.1377/hlthaff.2010.1022

Cite This Page:

New York University. "Pioneering hospital pay-for-performance program falls short of its goals, study finds." ScienceDaily. ScienceDaily, 9 June 2011. <www.sciencedaily.com/releases/2011/06/110609105530.htm>.
New York University. (2011, June 9). Pioneering hospital pay-for-performance program falls short of its goals, study finds. ScienceDaily. Retrieved July 23, 2014 from www.sciencedaily.com/releases/2011/06/110609105530.htm
New York University. "Pioneering hospital pay-for-performance program falls short of its goals, study finds." ScienceDaily. www.sciencedaily.com/releases/2011/06/110609105530.htm (accessed July 23, 2014).

Share This




More Health & Medicine News

Wednesday, July 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Courts Conflicted Over Healthcare Law

Courts Conflicted Over Healthcare Law

AP (July 22, 2014) Two federal appeals courts issued conflicting rulings Tuesday on the legality of the federally-run healthcare exchange that operates in 36 states. (July 22) Video provided by AP
Powered by NewsLook.com
Why Do People Believe We Only Use 10 Percent Of Our Brains?

Why Do People Believe We Only Use 10 Percent Of Our Brains?

Newsy (July 22, 2014) The new sci-fi thriller "Lucy" is making people question whether we really use all our brainpower. But, as scientists have insisted for years, we do. Video provided by Newsy
Powered by NewsLook.com
Scientists Find New Way To Make Human Platelets

Scientists Find New Way To Make Human Platelets

Newsy (July 22, 2014) Boston scientists have discovered a new way to create fully functioning human platelets using a bioreactor and human stem cells. Video provided by Newsy
Powered by NewsLook.com
Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins