Performance-for-Pay Incentives Improve Cardiovascular Care
(HealthDay News) – Performance-for-pay (P4P) incentives correlate with improvements in cardiovascular health care quality in electronic health record (EHR)-enabled small primary care clinics; and, EHR use is associated with less health care utilization among patients with diabetes, according to two studies published in the Sept. 11 issue of the Journal of the American Medical Association.
Naomi S. Bardach, MD, from the University of California in San Francisco, and colleagues conducted a cluster randomized trial involving small primary care clinics to examine the impact of P4P incentives on quality in EHR-enabled clinics. The researchers found that the intervention clinics had significantly greater adjusted absolute improvement in rates of appropriate antithrombotic prescription, blood pressure control, and smoking cessation interventions. On all measures except cholesterol control, intervention clinics performed better for Medicaid and uninsured patients, but the differences were not significant.
Mary Reed, DrPH, from Kaiser Permanente Northern California in Oakland, and colleagues examined the correlation between implementing a commercially available outpatient EHR and unfavorable events (emergency department visits and hospitalizations) and office visit use among patients with diabetes. In multivariate analysis, the researchers found that EHR use correlated with a significantly decreased number of emergency department visits and fewer hospitalizations. Similar statistically significant reductions were noted in non-elective hospitalizations and hospitalizations for ambulatory care-sensitive conditions. EHR use did not correlate significantly with office visit use.
"Among patients with diabetes, use of an outpatient EHR in an integrated delivery system was associated with modest reductions in emergency department visits and hospitalizations but not office visit rates," Reed and colleagues write.