Value-based incentive programs don't curb infection rates, study finds

Value-based incentive programs, which aim to drive quality improvements by linking financial incentives and penalties to hospital performance, did not lead to changes in one of the most common healthcare-associated infections, researchers report in JAMA.

CMS implemented the programs in 2013 to financially reward or penalize hospitals based on quality metrics. The programs targeted hospitals' rates of certain HAIs deemed preventable.  

The study, which is the first to look at how these programs affect HAI rates, focused on catheter-associated urinary tract infections in hospitals.

Researchers at Boston University School of Medicine and the Harvard Pilgrim Health Care Institute looked at changes in trends for different catheter-linked quality measures in about 600 U.S. hospitals.

They found no evidence that the value-based incentive programs had any measurable association with catheter-linked infection rates in the critical care units of U.S. hospitals.

Specifically, the researchers found the implementation of these programs was not linked to reductions in device-associated catheter infection rates, which the programs explicitly target.

"The good news for patients is that we found modest improvements over time in the use of urinary catheters in the critical care units of U.S hospitals, along with decreased risk for associated urinary tract infections in hospitalized patients. However, from a policy perspective, we did not find any evidence that the federal payment programs designed to motivate hospitals to engage in further prevention efforts made any difference," said corresponding author Heather Hsu, MD.

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