Quality-of-Care Incentives Lacking?

Journal of the

American Medical Association

When physicians have quality-of-care incentives inplace, they pay more attention to improvingpatient care. But according to a recent report, such incentivesare uncommon. In the first national study to confirma link between incentives to improve patient care anddoctors' actual use of care-management practices,one third of the 1040 US medical practices in the surveyreported no outside incentives to improve qualityin place. The lack of incentives also means that medicalpractices do not recoup the cost of the technologynecessary to put improved patient-care systems inplace. One problem, according to medical experts, isthat doctors typically get paid to diagnose and treat,not to manage the care of chronically ill patients.

The study looked at 16 processes for examiningpatients with asthma, congestive heart failure, diabetes,and depression, to determine whether medicalgroups use case-management techniques andwhether they give doctors in the group feedback onpatient-care guidelines. Half of the medical groups inthe study use no more than 4 of the 16 processes inthe survey. Almost 16% use none.

Third-party payers can improve the situation,study authors say, by developing financial incentivesfor medical groups so that they can invest in theinformation technology needed to fully implementeffective quality-of-care programs.