ArticleHealth services research2014
Does winning a pay-for-performance bonus improve subsequent quality performance? Evidence from the Hospital Quality Incentive Demonstration.
Article in Health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pay for performance for hospitals.The Cochrane database of systematic reviews · 2019Pooled it
- Does asthma pay-for-performance program really improve the quality of asthma care: a nationwide retrospective cohort analysis in Taiwan.BMC pulmonary medicine · 2025Article
- Evidence on the effectiveness of value-based payment schemes implemented in a hospital setting: A systematic review.Journal of education and health promotion · 2024Review
- Public Reporting on the Quality of Care in Patients with Acute Myocardial Infarction: The Korean Experience.International journal of environmental research and public health · 2022Article
- Performance Pay in Hospitals: An Experiment on Bonus-Malus Incentives.International journal of environmental research and public health · 2020Article
- Can Pay-for Performance Incentive Levels be Determined Using a Cost-Effectiveness Framework?Circulation. Cardiovascular quality and outcomes · 2020Article
- How are medical groups identified as high-performing? The effect of different approaches to classification of performance.BMC health services research · 2019Article
- Incentives in a public addiction treatment system: Effects on waiting time and selection.Journal of substance abuse treatment · 2018Article
- Impact assessment of a pay-for-performance program on breast cancer screening in France using micro data.The European journal of health economics : HEPAC : health economics in prevention and care · 2017Article
- Introducing Value-Based Purchasing into TRICARE Reform.Rand health quarterly · 2017Article
- Comprehensive healthcare resource use among newly diagnosed congestive heart failure.Israel journal of health policy research · 2017Article
- The Surgical Care Improvement Project Antibiotic Guidelines: Should We Expect More Than Good Intentions?Anesthesia and analgesia · 2015Article
- Racial disparities in outcomes after cardiac surgery: the role of hospital quality.Current cardiology reports · 2015Review
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
objectiveTo test whether receiving a financial bonus for quality in the Premier Hospital Quality Incentive Demonstration (HQID) stimulated subsequent quality improvement. DATA: Hospital-level data on process-of-care quality from Hospital Compare for the treatment of acute myocardial infarction (AMI), heart failure, and pneumonia for 260 hospitals participating in the HQID from 2004 to 2006; receipt of quality bonuses in the first 3 years of HQID from the Premier Inc. website; and hospital characteristics from the 2005 American Hospital Association Annual Survey. STUDY
designUnder the HQID, hospitals received a 1 percent bonus on Medicare payments for scoring between the 80th and 90th percentiles on a composite quality measure, and a 2 percent bonus for scoring at the 90th percentile or above. We used a regression discontinuity design to evaluate whether hospitals with quality scores just above these payment thresholds improved more in the subsequent year than hospitals with quality scores just below the thresholds. In alternative specifications, we examined samples of hospitals scoring within 3, 5, and 10 percentage point "bandwidths" of the thresholds. We used a Generalized Linear Model to estimate whether the relationship between quality and lagged quality was discontinuous at the lagged thresholds required for quality bonuses. PRINCIPAL
findingsThere were no statistically significant associations between receipt of a bonus and subsequent quality performance, with the exception of the 2 percent bonus for AMI in 2006 using the 5 percentage point bandwidth (0.8 percentage point increase, p<.01), and the 1 percent bonus for pneumonia in 2005 using all bandwidths (3.7 percentage point increase using the 3 percentage point bandwidth, p<.05).
conclusionsWe found little evidence that hospitals' receipt of quality bonuses was associated with subsequent improvement in performance. This raises questions about whether winning in pay-for-performance programs, such as Hospital Value-Based Purchasing, will lead to subsequent quality improvement.
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