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Putting smart money to work for quality improvement.
Nancy Dean Beaulieu1, Dennis R Horrigan
1Harvard Business School, Mellon Hall A4-5, Soldiers Field, Boston, MA 02163, USA.
Health Services Research
|September 22, 2005
Summary
Financial incentives improved diabetes care quality when combined with care management tools. This pilot program showed significant gains in process and outcome measures for diabetic patients.
Area of Science:
- Health Services Research
- Quality Improvement
- Diabetes Management
Background:
- Quality of diabetes care can be improved through targeted interventions.
- Financial incentives are increasingly explored as a method to enhance healthcare provider performance.
Purpose of the Study:
- To evaluate the impact of performance-based physician payments on diabetes care quality.
- To assess the effectiveness of combining financial incentives with care management tools.
Main Methods:
- A pilot program offered financial rewards to physicians for quality diabetes care.
- Physicians received a diabetic registry and participated in group discussions.
- A pre/post design with a control group was used to evaluate changes in care quality.
Main Results:
- Significant improvements were observed in five of six process measures and two of three outcome measures (HbA1c and LDL control).
- A majority of participating physicians (13/21) achieved performance bonuses.
- Even physicians not receiving rewards showed improved composite scores.
Conclusions:
- Bundled financial incentives and care management tools effectively improved objective quality of diabetes care.
- Physician self-selection and small sample size may limit the generalizability of findings.