A pay-for-performance program at hospitals was not associated with significant improvement in processes of care or outcomes for heart attack patients, according to a study reported in the June 6 issue of JAMA.
Researchers examined whether hospitals participating in the pay-for-performance program showed improvement in certain process measures and outcomes for treatment of heart attack beyond that in hospitals not participating in the quality improvement program. The study included an analysis of data for 105,383 patients with a certain type of myocardial infarction. Patients were treated between July 2003 and June 2006 at 54 hospitals in the CMS program and 446 control hospitals.
The researchers found no significant difference in the rate of improvement in the composite score between the two hospital groups. Two of the six CMS measures, aspirin prescription at discharge and smoking cessation counseling, had slightly higher rates of improvement at pay-for-performance hospitals than control hospitals. For composite measures of heart attack treatments not subject to incentives, rates of improvement were not significantly different. There was a slight reduction in the rate of deaths over time at both pay-for-performance and control hospitals, although the difference in the rate of the reductions between the groups was not statistically significant. Read the abstract.
