Physicians soon may receive incentives for referring patients to hospitals that meet certain quality criteria for high-risk treatments, under a pilot program sponsored by the Leapfrog Group.
The incentive program is one of several programs intended to promote quality that the Washington-based consortium of major healthcare purchasers will launch in coming months, according to François de Brantes, liaison to the Leapfrog Group for General Electric Co.
The Leapfrog Group will announce "four or five" pilot programs aimed at implementing its acute care recommendations during the second quarter of the year, de Brantes says. Another will include financial incentives for hospitals to hire intensivists, he says.
"If we're going to hold others accountable, we're going to have to hold ourselves accountable," de Brantes explains. "We need to add robust financial rewards for performance."
However, he says the focus will remain on acute care for at least another year and a half. "The earliest we will venture into ambulatory care is late 2004 or early 2005," de Brantes says.
De Brantes made the comments Wednesday at the annual Healthcare Information and Management Systems Society meeting in San Diego.
De Brantes is careful to say the yet-unspecified incentives for evidence-based referrals will not include bonuses and likely will come from third-party administrators for self-insured corporations rather than from health plans, thus avoiding violations of the anti-kickback provisions of the so-called Stark rules governing referrals. He says Leapfrog participants have yet to decide on the exact mechanism.
The Leapfrog Group also has asked hospitals to update their survey data-some of which is nearly two years old-during the third quarter of 2003. De Brantes says new results will be released before the end of the year.
He also refutes the oft-repeated criticism that the Leapfrog call for evidence-based hospital referral will favor high-volume hospitals at the expense of smaller, community facilities. "The criteria at Leapfrog is not volume, it's an outcomes-based measure," de Brantes says.