Effects of Individual Physician-Level and Practice-Level Financial Incentives on Hypertension Care

Abstract

As part of the Affordable Care Act, the US government has introduced pay for performance to all hospitals paid by Medicare nationwide.¹ The New York City Health and Hospitals Corporation recently announced a performance pay plan for physicians.² These and other value-based purchasing systems are intended to align incentives to promote high-quality health care.³ Evaluations of the effectiveness of pay-for-performance programs directed at hospitals have shown contradictory results.^3-5 The Premier Hospital Quality Incentive Demonstration showed an increase of up to 4.1 percentage points in process-quality measures during the first 2 years,⁶ but these modest gains were not sustained.⁷ Moreover, risk-adjusted mortality in the same program showed no improvement.⁸