Physician financial incentives and feedback: failure to increase cancer screening in Medicaid managed care.
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.
Hillman
A L
AL
University of Pennsylvania, Philadelphia, USA.
Ripley
K
K
Goldfarb
N
N
Nuamah
I
I
Weiner
J
J
Lusk
E
E
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