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Alternative Quality Contract Improves Quality Measures

Findings for outcomes tied to pay-for-performance; doesn't affect per capita spending

FRIDAY, Dec. 27, 2013 (HealthDay News) -- A global budget arrangement, the Alternative Quality Contract (AQC), improves preventive care quality measures for outcomes tied to pay-for-performance (P4P), according to a study published online Dec. 23 in Pediatrics.

Alyna T. Chien, M.D., from Boston Children's Hospital, and colleagues compared quality and spending trends pre (2006 to 2008) and post (2009 to 2010) AQC implementation for 126,975 unique 0 to 21 year olds receiving care from AQC groups and 415,331 propensity-matched patients receiving care from non-AQC groups. Children with special health care needs (CSHCN) accounted for 23 percent of enrollees. Outcome measures tied to P4P included four preventive and two acute care measures, whereas three asthma and two attention-deficit/hyperactivity disorder quality measures were not tied to P4P.

The researchers found that pediatric care quality tied to P4P increased by 1.8 percent for CSHCN (P < 0.001) and 1.2 percent for non-CSHCN (P < 0.001) for AQC versus non-AQC groups during the first two years of the AQC. There were no significant changes in quality measures not tied to P4P. There was no significant impact of the AQC on spending trends for children.

"During the first two years of the contract, the AQC had a small but significant positive effect on pediatric preventive care quality tied to P4P; this effect was greater for CSHCN than non-CSHCN," the authors write.

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