Paying doctors and hospitals for better outcomes may not pay off

Medicare's largest effort to pay bonuses to hospitals that hit key performance measures -- or dock them if they miss --  did not lead to fewer deaths for heart attacks and heart bypass surgery, a new study finds. The analysis could lead to a reexamination of the idea of paying providers based on quality metrics, rather than on volume, which is key to the health law.

Kaiser Health News: Effort To Pay Hospitals Based On Quality Didn't Cut Death Rates, Study Finds
Medicare's largest effort to pay hospitals based on how they perform -; an inspiration for key parts of the health care law -; did not lead to fewer deaths, a new study has found. The study casts doubt on a central premise of the health law's effort to rework the financial incentives for hospitals with the aim of saving money while improving patient care (Rau, 3/28).

Reuters: Hospital Pay Incentives Fail To Help Patients: Study
A program to pay hospitals bonuses for hitting key performance measures, or dock them if they miss, failed to improve the health outcomes of patients, according to a large, long-term study. The study could lead to a re-examination of financial incentives in healthcare, as policymakers seek ways to reward results rather than paying doctors and other providers for each service they provide, such as a diagnostic test. Such an incentive program for hospitals is a key provision of the U.S. healthcare overhaul law that is being challenged this week before the Supreme Court (Krauskopf, 3/28).

National Journal: Paying For Better Outcomes May Not Improve Care
One of the planks of the 2010 health care law, paying hospitals to improve the quality of care, doesn't appear to help patients survive any better, researchers reported on Wednesday. They compared two hospital systems over six years – one that took part in the so-called pay for performance plan offered by the Centers for Medicare and Medicaid Services, and one that didn't. More than 6 million patients went through the 3,600 hospitals from 2003 to 2009. Ashish Jha of the Harvard School of Public Health and colleagues looked at how many patients died within 30 days after being treated for heart attacks, congestive heart failure or pneumonia or who had heart bypass surgery (Fox, 3/28).

WBUR's CommonHealth blog: Pay-For-Performance May Not Pay Off, Study Finds
Lead author Ashish Jha says it may be that doctors weren't paid enough to compel change or that the payments weren't based on meaningful measures. "A lot of us believe that paying for performance is a good thing but how we do it is still something we don't understand," he said (Bebinger, 3/29).