Quality improvement incentives may not produce greater improvement among hospitals with low-initial performance, according to a study published in Health Affairs.
The study found that the joint CMS-Premier Hospital Quality Incentive Demonstration, which launched in 2003, had no significant effect on the performance improvement of hospitals in the lowest initial quartile. The researchers noted that the lower-performing hospitals improved at the same rate as other providers.
Officials updated the HQID's incentives design in 2006, but the researchers said those changes benefited providers with initial quality that was just above the median and did not properly target hospitals with low initial performance on quality measures, such as heart attack, heart failure and pneumonia.
According to study authors, the findings "raise questions about whether pay-for-performance strategies that reward improvement can generate greater improvement among lower-performing providers." The study also casts doubts on the power of economic incentives to improve hospital performance, the add.
CMS is scheduled to launch a nationwide value-based purchasing program in fiscal year 2013. The program is modeled on the Premier initiative, will offer incentives based on performance in six categories, and includes more than 250 hospitals (AHA News Now, 4/9; Selvam, Modern Healthcare, 4/10 [subscription required]).