Posted October 4, 2006
Patient Safety and Quality Healthcare: News
Findings Validate Potential of Pay for Performance in Improving Hospital Quality
Findings from a national pay-for-performance (P4P) project led by the Premier Inc. healthcare alliance under the auspices of the Centers for Medicare and Medicaid Services validate the potential for P4P to accelerate quality improvement in the nation's hospitals.
An Institute of Medicine report calls for the Department of Health and Human Services and CMS to phase in pay for performance gradually as a means to improve quality of care for the nation's 42 million Medicare beneficiaries.
The CMS/ Premier Hospital Quality Incentive Demonstration Project involves more than 250 hospitals from across the nation that submit data on 33 quality measures to Premier and CMS for analysis. The top 20 percent of hospitals in each clinical condition receive incentive payments from Medicare.
"Quality of care among the hospitals participating in this project has improved more rapidly than among the nation's hospitals as a whole — so we can say definitively that pay for performance can accelerate improvement," said Stephanie Alexander, Premier senior vice president and member of the IOM subcommittee on pay for performance. "We've also seen significant improvements in patient outcomes and the cost of care."
Specifically, Premier has found that if all pneumonia, heart bypass, acute myocardial infarction, and hip and knee replacement patients nationally received most of a set of widely accepted care steps — 76 percent or more — outcomes would include 5,700 fewer deaths, 8,100 fewer complications, 10,000 fewer readmissions and 750,000 fewer days in the hospital.
According to an analysis of publicly reported quality data, hospitals in the CMS/Premier P4P project outperform their counterparts nationally on a composite score of 17 quality measures by 84.86 percent to 79.13 percent.
"Phasing in pay for performance gradually will give all stakeholders the opportunity to thoroughly explore the impact of various quality measures and incentive models," Alexander said. "Based on the early results of the CMS/Premier demonstration project, we believe that pay for performance can accelerate clinical and financial performance, which is good for all of us — as taxpayers and patients."
"Rewarding Provider Performance: Aligning Incentives in Medicare" is the third report in the IOM's Pathways to Quality Health Care series. Information about the report is available at: http://www.iom.edu/Default.aspx?id=36909.
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