Pay-for-performance (P4P) does not result in providers cherry-picking patients, nor does it cause a negative impact on patient outcomes, according to a new study by researchers from the American College of Surgeons (ACS), released at the ACS Clinical Congress in San Francisco on Thursday.
Researchers said they studied 1,768 patient cases for eight different types of major operations, including gastric bypass and lung procedures.
They investigated data from databases kept by the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) and the Society of Thoracic Surgeons on surgeries that were performed at three New York City hospitals from 2007 through 2010.
Investigators found that complications and death rates did not change appreciably after pay-for-performance programs were initiated, reported lead investigator Faiz Bhora, MD, associate program director, general surgery program, St. Lukes-Roosevelt Hospital Center.
Some stakeholders have been concerned that pay-for-performance programs will cause physicians to avoid treating sicker, frailer patients in order to make their outcomes look better. Bhora said this study found no evidence of that.
[See also: P4P could hurt poor, minorities.]
“Our case mix index was no different before or after pay for performance; there was no evidence of cherry picking of cases,” he said.
Bhora said this is one of the first studies of pay for performance that has looked at patient outcomes.
The ACS research team said quality care outcomes should be the essential framework for pay-for-performance programs.
“There’s always a concern that incentive programs may affect the quality of care,” said Bhora. "That’s where we as physicians need to stay engaged with pay-for-performance programs, so that it’s not just a financial program, but a quality program as well.”
[See also: P4P programs' ability to improve care 'questionable at best'.]
Follow Diana Manos on Twitter: @DManos_IT_News.
