Judith Hibbard, Jessica Greene, Rebecca M. Sacks, Valerie Overton
J. H. Hibbard, J. Greene, R. Sacks et al., “Does Compensating Primary Care Providers to Produce Higher Quality Make Them More or Less Patient Centric?” Medical Care Research and Review, published online May 11, 2015.
Engaging patients in behavior change is critical to improving health outcomes, which depend in part on decisions about diet, exercise, and managing chronic conditions. Patients’ choices and behaviors can also influence how providers perform on quality measures. To see whether primary care providers would increase their efforts to engage patients in behavior change when a large percentage of their compensation depended on performance, the authors of this Commonwealth Fund-supported study looked at the interactions between doctors and patients at Fairview Health Services, a large integrated delivery system that tied 40 percent of primary care physicians’ compensation to quality metrics.
The findings suggest that incentivizing quality through pay-for-performance programs may be insufficient to motivate primary care providers to engage patients in behavior change because they don’t see it as a productive use of time. It may be necessary to provide incentives to increase patient activation as an intermediate step.