Study looks at impact of changes in pay-for-performance demonstration

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Rewarding quality improvement may not generate greater improvement among lower performing hospitals, according to a study published today in Health Affairs. The study found no evidence that hospitals in the lowest initial quartile of performance of the Premier Hospital Quality Incentive Demonstration improved their performance after the Medicare demonstration added quality improvement incentives to the existing incentives for attaining certain performance levels. "We estimate that the change in incentive design provided the strongest financial incentive not to hospitals with the lowest initial quality, but to hospitals whose initial quality was just above the median," the authors state. "However, these hospitals did not improve disproportionately more in phase 2 than hospitals in the other quartiles of initial quality."

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