New pay-for-performance approach could motivate more docs to participate

Physicians would be reimbursed more for helping patients in need

If insurers implemented a new pay-for-performance approach, they could help motivate more doctors caring for disadvantaged patients to sign up for the payment model, according to a study conducted by RAND Corp. and published in the journal Health Affairs.

Although many pay-for-performance models have been successful at lowering costs and boosting quality, as FierceHealthPayer has reported, they often fail to compel doctors to provide care to disadvantaged patients. This includes people who don't have economic or social support to go to appointments or take prescribed medications.

"Incentive programs run the risk of encouraging providers to avoid patients who may have greater challenges in meeting quality targets that providers are now being held accountable for," Cheryl Damberg, the study's lead author and distinguished chair in healthcare payment policy for RAND, said in a statement.

That's why the RAND researchers developed a pay-for-performance method that changes the amount of money that insurers reimburse doctors who care for certain patients, including those with low socioeconomic status.

"Our pay-for-performance approach strengthened quality-based incentive payments to providers who care for disadvantaged patients, while only slightly weakening incentives for other provider organizations and eliminating the redistribution of money to well-resourced providers," said Marc Elliott, study co-author and RAND distinguished chair in statistics.

Simulating the payment's effect by analyzing 153 provider organizations in California that were eligible for incentive payments in 2009 as a part of a pay-for-performance program, the researchers determined that their model almost doubled payments to providers caring for disadvantaged patients.

To learn more:
- read the Health Affairs study
- here's the RAND statement

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