Physician researchers in Canada recently published findings that suggest tying financial incentives to quality of care may not be working as anticipated.
The study analyzed administrative data for more than 750,000 patients with diabetes in Ontario and assessed testing rates for the patients over time before and after physicians were part of a government-sponsored incentive program. Starting in 2002, the Canadian began incentivizing primary care physicians, through a coding system monetary bonus, to encouraging monitoring testing for diabetic patients.
While the proportion of patients who received tests improved from 16 percent in 2000 to 27 percent in 2008, the study found that patients who received an optimal number of monitoring tests after the incentive period were already receiving proper recommendations from primary care physicians before the incentives kicked in.
"The diabetes incentive code led to minimal improvement in quality of diabetes care at the population and patient level," conclude the physicians who conducted the study. "Our findings suggest that physicians who provide the highest quality care prior to incentives may be those most likely to claim incentive payments."
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The study analyzed administrative data for more than 750,000 patients with diabetes in Ontario and assessed testing rates for the patients over time before and after physicians were part of a government-sponsored incentive program. Starting in 2002, the Canadian began incentivizing primary care physicians, through a coding system monetary bonus, to encouraging monitoring testing for diabetic patients.
While the proportion of patients who received tests improved from 16 percent in 2000 to 27 percent in 2008, the study found that patients who received an optimal number of monitoring tests after the incentive period were already receiving proper recommendations from primary care physicians before the incentives kicked in.
"The diabetes incentive code led to minimal improvement in quality of diabetes care at the population and patient level," conclude the physicians who conducted the study. "Our findings suggest that physicians who provide the highest quality care prior to incentives may be those most likely to claim incentive payments."
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