Less than one year after the CMS renewed a demonstration pay-for-performance project for another three years, a new study suggests it may not be working as hoped.
Financial incentives did not appear to make all that much difference in improving outcomes in one of the first studies evaluating the landmark pilot project in collaboration with the Premier hospital alliance.
To be sure, processes and outcomes improved for heart attack patients at participating hospitals, but hospitals that are participating in a quality-improvement program that does not offer financial rewards improved equally. The study thus raises questions as to whether money spent to reward hospitals for their improvement efforts is really money well-spent.
CMS and Premier officials welcomed the study, acknowledging the pilot projectwhich was launched in 2003was undertaken in part to promote more research on the pay-for-performance issue. But they also said there are other indications that even the modest monetary incentives offered by the CMS pilot project seem to have produced encouraging results.
We have heard back from our Premier hospitals that their inclusion (in the pilot program) and the effort that they are putting in is giving them additional impetus toward quality improvement, said Mark Wynn, the CMS director of the division of the payment policy demonstrations. It is not very much money we are talking about, but it gives focus to the quality improvement that is very beneficial.