Pay for Performance May Not Improve Mortality Rates

Researchers suggest hospital-based pay for performance programs may not improve mortality rates over the long term, according to a study published in the New England Journal of Medicine.

For this study, researchers compared the performance of 252 hospitals that participated in the Medicare Premier Hospital Quality Incentive Demonstration to 3,363 hospitals that only participating in public reporting. Outcomes measured included 30-mortality rates among patients with acute myocardial infarction, congestive heart failure or pneumonia or who underwent coronary-artery bypass grafting from 2003 to 2009.

The study authors found 30-day mortality rates were similar for Premier hospitals (12.33 percent) and control hospitals (12.4 percent). They also found 30-day mortality reductions per quarter and 30-day mortality rates after six years remained largely the same between the two hospital groups. In addition, mortality rates for conditions linked to incentives (acute myocardial infarction and CABG) did not differ from mortality rates for conditions not linked to incentives (congestive heart failure and pneumonia).

The authors suggested expectations for pay-for-performance programs like the one studied should remain "modest."

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