A Medicare pay-for-performance pilot project that rewards hospitals based on quality measures contributes to "modest" improvements in quality of care, according to a study published online Friday in the New England Journal of Medicine, the Wall Street Journal reports (Tomsho, Wall Street Journal, 1/29).
The project, which launched in October 2003, includes about 260 hospitals in 38 states. Under the program, hospitals can earn bonuses if they rank among the top 20% in providing specified treatments in at least one of five areas of patient care: joint replacement, coronary artery bypass graft, heart attack, heart failure and pneumonia. CMS officials on Friday announced that the three-year pay-for-performance pilot program has improved patient care. CMS officials on Friday also announced that performance bonuses of $8.7 million will be awarded to 115 hospitals that were the top performers based on 30 quality measures in the second year of the project. Premier, a not-for-profit hospital alliance, is managing the program (Kaiser Daily Health Policy Report, 1/25). For the NEJM study, researchers compared results over a two-year period from 207 hospitals taking part in the CMS project with 406 hospitals that were not offered quality-care reimbursements. Both groups of hospitals were participating in efforts to publicize quality-of-care data. The study found that hospitals in the pay-for-performance program had greater improvement overall in all combined measures of quality. Researchers found that hospitals involved in the pay-for-performance program had a 2.6% improvement in treatment for heart attack patients and a 3.4% improvement in care for pneumonia patients compared with hospitals not in the program (Wall Street Journal, 1/29). The bonuses were relatively small, accounting for 1% to 2% of the cost of providing care for patients with one of the evaluated conditions.