JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study
Effects of individual physician-level and practice-level financial incentives on hypertension care: a randomized trial.
Pay for performance is intended to align incentives to promote high-quality care, but results have been contradictory. ⋯ Individual financial incentives, but not practice-level or combined incentives, resulted in greater blood pressure control or appropriate response to uncontrolled blood pressure; none of the incentives resulted in greater use of guideline-recommended medications or increased incidence of hypotension compared with controls. Further research is needed on the factors that contributed to these findings.
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Randomized Controlled Trial Multicenter Study
Effect of pay-for-performance incentives on quality of care in small practices with electronic health records: a randomized trial.
Most evaluations of pay-for-performance (P4P) incentives have focused on large-group practices. Thus, the effect of P4P in small practices, where many US residents receive care, is largely unknown. Furthermore, whether electronic health records (EHRs) with chronic disease management capabilities support small-practice response to P4P has not been studied. ⋯ Among small EHR-enabled clinics, a P4P incentive program compared with usual care resulted in modest improvements in cardiovascular care processes and outcomes. Because most proposed P4P programs are intended to remain in place more than a year, further research is needed to determine whether this effect increases or decreases over time.