title: Physician financial incentives and feedback: failure to increase cancer screening in Medicaid managed care.
abstract: OBJECTIVE
  A randomized controlled trial evaluated the impact of feedback and financial incentives on physician compliance with cancer screening guidelines for women 50 years of age and older in a Medicaid health maintenance organization (HMO).
  
  
  METHODS
  Half of 52 primary care sites received the intervention, which included written feedback and a financial bonus. Mammography, breast exam, colorectal screening, and Pap testing compliance rates were evaluated.
  
  
  RESULTS
  From 1993 to 1995, screening rates doubled overall (from 24% to 50%), with no significant differences between intervention and control group sites.
  
  
  CONCLUSIONS
  Financial incentives and feedback did not improve physician compliance with cancer screening guidelines in a Medicaid HMO.
authors.affiliation: University of Pennsylvania, Philadelphia, USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Hillman
authors.forename: K
authors.initials: K
authors.lastname: Ripley
authors.forename: N
authors.initials: N
authors.lastname: Goldfarb
authors.forename: I
authors.initials: I
authors.lastname: Nuamah
authors.forename: J
authors.initials: J
authors.lastname: Weiner
authors.forename: E
authors.initials: E
authors.lastname: Lusk
mesh_terms: D000368:Aged; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D006279:Health Maintenance Organizations / Q000191:economics / Q000592:standards*; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008484:Medicaid / Q000592:standards*; D008485:Medical Audit; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control*; D015143:Philadelphia; D010816:Physician Incentive Plans / Q000191:economics* / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D012052:Reimbursement, Incentive; D014481:United States; D016387:Women's Health