title: Does pay for performance improve cardiovascular care in a "real-world" setting?
abstract: The objective was to investigate the impact of a pay-for-performance program (P4P) on quality care and outcomes among cardiovascular disease (CVD) patients. Claims data were used to identify CVD patients in a commercial plan in 1999-2006. Multivariate analyses were employed to examine the impact of P4P on quality care (lipid monitoring and treatment) and quality care on outcomes (new coronary events, hospitalizations, and lipid control). Patients who were treated by physicians participating in P4P were more likely to receive quality care than patients who were not. Patients who received quality care were less likely to have new coronary events (odds ratio [OR] = 0.80; 95% confidence interval [CI] = 0.69-0.92), be hospitalized (OR = 0.76; 95% CI = 0.69-0.83), or have uncontrolled lipids (OR = 0.67; 95% CI = 0.61-0.73) than patients who did not. A P4P program was associated with increased lipid monitoring and treatment. Receipt of this quality care was associated with improved lipid control and reduced likelihood of new coronary events and hospitalizations.
authors.affiliation: IMS Health, Woodland Hills, CA 91367, USA. Judy.Chen@us.imshealth.com
authors.forename: Judy Ying
authors.initials: JY
authors.lastname: Chen
authors.forename: Haijun
authors.initials: H
authors.lastname: Tian
authors.forename: Deborah Taira
authors.initials: DT
authors.lastname: Juarez
authors.forename: Irina
authors.initials: I
authors.lastname: Yermilov
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Braithwaite
authors.forename: Krista A
authors.initials: KA
authors.lastname: Hodges
authors.forename: Antonio
authors.initials: A
authors.lastname: Legorreta
authors.forename: Richard S
authors.initials: RS
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000191:economics / Q000628:therapy*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D012052:Reimbursement, Incentive / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008055:Lipids