Diabetic patients treated by physicians who received pay-for-performance incentives received better care and had better clinical outcomes than those whose physicians were not involved in the program, according to researchers at IMS Health.
To reach these conclusions, Judy Chen and colleagues looked at the records of diabetic patients who received care from the Hawaii Medical Services Association, a large PPO between 1999 and 2006. HMSA had 19,600 diabetic at study onset and about 32,000 by 2006.
HMSA offered its physicians the opportunity to earn bonuses ranging between 1.5% and 7.5% of their base fees if they met quality-of-care targets including the use of HbA1c and LDL cholesterol testing for their diabetic patients. Beginning in 2001, participating physicians could earn nearly $6,000 in bonuses if their adherence to specified care requirements improved versus the previous year.
The provider organization defined high-quality care as receiving at least 2 tests for HbA1c and one test for LDL cholesterol in a given year.
Chen’s group found that physicians who were enrolled in the P4P program delivered high quality care 16% more frequently than physicians who were not so enrolled. The patients of physicians who participated in P4P for at least 3 consecutive years were also found to be 25% less likely to be hospitalized.
“This study showed a robust, consistent, significant, and positive association between increased receipt of appropriate laboratory monitoring of A1c and LDL cholesterol levels and decreased hospitalization rates,” Chen’s group wrote.
The proportion of diabetic patients seen by physicians enrolled in the P4P plan jumped from 79% in 1999 to 95% in 2006.
The write up is in the American Journal of Managed Care.