Rachel Werner, Jonathan Kolstad, Elizabeth Stuart, Daniel Polsky (2013), The Effect of Pay for Performance in Hospitals: Lessons for Quality Improvement, Health Affairs, 30 (4), pp. 690-698.
Abstract: The payment approach known as “pay-for-performance” has been widely adopted with the aim of improving the quality of health care. Nonetheless, little is known about how to use the approach most effectively to improve care. We examined the effects in 260 hospitals of a pay-for-performance demonstration project carried out by the Centers for Medicare and Medicaid Services in partnership with Premier Inc., a nationwide hospital system. We compared these results to those of a control group of 780 hospitals not in the demonstration project. The performance of the hospitals in the project initially improved more than the performance of the control group: More than half of the pay-for performance hospitals achieved high performance scores, compared to fewer than a third of the control hospitals. However, after five years, the two groups’ scores were virtually identical. Improvements were largest among hospitals that were eligible for larger bonuses, were well financed, or operated in less competitive markets. These findings suggest that tailoring pay-for-performance programs to hospitals’ specific situations could have the greatest effect on health care quality.
HPR 607 - HLTH SVC POL RES METH II
Empirical research for health care policy frequently involves the analysis of observational data--information that is not primarily collected for research purposes. With the rapid increase in U.S. health information technology capacity, future opportunities for research using these "secondary data" appear promising. The objective of this course is to teach the skills necessary to conduct quality health policy research using secondary data. These skills include formulating research aims and applying appropriate study designs for achieving these aims. The course will also include a survey of the content and structure of several commonly used administrative and public databases available to researchers and workshops to develop the skills to access and manipulate these valuable resources. Prerequisite: Permission needed from Instructor.