Study: When incentive payments are removed, quality of health care suffers

May 13 2010

Los Angeles Times: Researchers in Britain teamed with Kaiser Permanente in Northern California "to see what happened in Northern California when the health giant stopped rewarding doctors who screened patients for diabetic retinopathy and cervical cancer."

"Between 1999 and 2003, when Kaiser physicians were rewarded for screening diabetic patients for diabetic retinopathy -- a complication that can cause severe vision loss, including blindness -- the screening rate rose from 84.9% to 88.1%. Then the incentive payments stopped, and the screening rate dropped to 80.5% four years later. ... it has been shown that once people get paid to do something, they're less likely to do it for free." The study is in the British Medical Journal (Kaplan, 5/11). 

eHealthInsider: "Rates of cervical screening also rose when financial incentives were attached and fell during the five years when they were removed, climbing once more when incentives were reattached for two years. Rates for hypertension control and glycaemic control improved when financial incentives were offered. The research team said that if further research confirms that removal of financial incentives meant performance levels, and potentially patient care, declined there may be practical implications for policymakers, clinicians and patients" (Barr, 5/12).