Pay-for-performance does not result in better care, study finds

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Hospitals that received financial incentives to follow heart attack guidelines did not necessarily provide better care, a new study found.

Researchers at Duke University compared treatments and outcomes for five conditions at hospitals in a pay-for-performance pilot with hospitals not in the program. Overall, there was no evidence that improvements in in-hospital mortality were incrementally greater at pay-for-performance sites. Results of the three-year study appeared in the Journal of the American Medical Association.

Researchers studied examined factors such as whether heart attack patients were prescribed aspirin, beta-blockers and ACE inhibitors. The researchers also tracked whether patients were advised to quit smoking. Hospitals in the program received bonuses if they reached certain performance levels for a given condition. The Centers for Medicare & Medicaid Services has considered pay-for-performance initiatives in the area of long-term care.