Individual Physician-Level Incentives Improve BP Control
But neither physician- nor practice-level incentives increase use of guideline-recommended meds
TUESDAY, Sept. 10 (HealthDay News) -- Individual physician-level financial incentives are associated with greater blood pressure control or appropriate response to uncontrolled blood pressure, but neither physician-level nor practice-level incentives result in greater use of guideline-recommended medications, according to a study published in the Sept. 11 issue of the Journal of the American Medical Association.
Laura A. Peterson, M.D., M.P.H., from the Health Services Research and Development Center of Excellence in Houston, and colleagues examined the effect of explicit financial incentives at the physician level, practice level, or both to reward guideline-recommended hypertension care. A total of 83 primary care physicians and 42 non-physician personnel were enrolled from 12 Veterans Affairs outpatient clinics with five performance periods and a 12-month washout.
The researchers found that the mean total payments were $4,270 for the combined group, $2,672 for the individual physician-level group, and $1,648 for the practice-level group. Compared with the control group, only in the individual incentives group was the change in blood pressure control or appropriate response to uncontrolled blood pressure significantly increased. There was no significant change in guideline-recommended medication use compared with the control group. After a washout, the effect of the incentive was not sustained.
"Individual financial incentives, but not practice-level or combined incentives, resulted in greater blood pressure control or appropriate response to uncontrolled blood pressure," the authors write. "None of the incentives resulted in greater use of guideline-recommended medications or increased incidence of hypotension compared with controls. Further research is needed to understand the factors that contributed to these findings."