Provider Perspectives on Quality Payment Programs Targeting Diabetes in Primary Care Settings

Area of Science:

• Health Services Research
• Primary Care Medicine
• Health Policy and Insurance

Background:

• Insurers utilize quality payment programs (QPPs) to enhance care quality in primary care.
• Limited understanding exists regarding primary care providers' (PCPs) views on QPP effectiveness for diabetes care quality.

Purpose of the Study:

• To explore PCPs' perspectives on the impact and mechanisms of QPPs on diabetes quality of care.
• To identify provider-recommended strategies for improving QPPs and addressing care barriers.

Main Methods:

• Qualitative study employing semi-structured interviews and focus groups.
• Involved 23 primary care providers.
• Data analyzed using the immersion-crystallization method to identify key themes.

Main Results:

• Most PCPs believe insurers significantly influence diabetes care quality, preferably through providers/systems.
• QPPs generally perceived positively, enhancing population health management systems and staffing, not direct physician incentives.
• Some skepticism noted regarding QPP impact and observed negative consequences.

Conclusions:

• PCPs see value in QPPs, particularly when supporting infrastructure for population health management.
• Recommendations include refining quality measures, providing feedback, and addressing systemic barriers.
• Further strategies are needed to optimize QPPs for improved diabetes care delivery.