Hector P. Rodriguez, Ph.D., M.P.H., Ted von Glahn, M.S., Marc N. Elliott, Ph.D., William H. Rogers, Ph.D. and Dana Gelb Safran, Sc.D.
H. P. Rodriguez, T. von Glahn, M. N. Elliott et al., "The Effect of Performance-Based Financial Incentives on Improving Patient Care Experiences: A Statewide Evaluation," Journal of General Internal Medicine, Dec. 2009 24(12):1281–88.
Pay-for-performance programs are increasingly used to improve the quality of health care delivered by physicians, and measures of patient experience play a central role in many of these incentives. Whether such programs are effective, however, has not been assessed. In this Commonwealth Fund–supported study, researchers examined whether performance-based financial incentives for medical groups were associated with improved primary care patient experiences.
The researchers surveyed patients who visited primary care providers belonging to 25 California medical groups operating under pay-for-performance arrangements, and also interviewed the medical directors at those facilities. They found that performance on communication, care coordination, and office staff interactions measures improved significantly over the course of the study. Physicians with lower initial performance scores experienced the largest improvements. Incentive programs that had a greater emphasis on clinical quality and patient experience were associated with larger improvements in physician scores. In contrast, an emphasis on productivity and efficiency was associated with worse performance.
Patients' care experiences significantly improved when their primary care doctors operated under a financial incentive program.