Paying hospitals to improve doesn’t work
Paying hospitals to improve their quality of care, known as pay-for-performance, has gained wide acceptance in the U.S., and Medicare has spent tens of millions of dollars on bonuses and rewards for hospitals to improve. However, little is known about whether pay-for-performance (P4P) actually improves patient outcomes over the long term. A new study from Harvard School of Public Health (HSPH) finds no evidence that the largest hospital-based P4P program in the U.S. improved 30-day mortality rates, a measure of whether patients survive their hospitalization. Given that the Affordable Care Act calls for the Centers for Medicare and Medicaid Services (CMS) to expand pay-for-performance to nearly all hospitals in 2012, the findings call into question whether this payment approach will have a beneficial effect on patient care. The study appears online March 28 in the New England Journal of Medicine. “These results suggest that the way we have currently conceived of pay-for-performance is...