title: Outcomes of a Seven Practice Pilot in a Pay-For-Performance (P4P)-Based Program in Pennsylvania.
abstract: OBJECTIVE
  The objective of this study was to examine how targeted six-month interventions impacted Best Practice/Patient Outcomes for minority patients receiving primary care in physician practices participating in a pay-for-performance (P4P) program.
  
  
  METHODS
  P4P Practices were invited to participate in a pilot intervention study designed to improve care for minority patients with hypertension, diabetes or pediatric asthma. Patient medical records were reviewed to assess how the interventions impacted (n=7 practices): Body mass index, diet and exercise, smoking, compliance with visits as recommended, blood pressure, sodium intake and weight management counseling, medication reconciliation, HbA1c testing, annual lipid profile, and anti-inflammatory medications.
  
  
  RESULTS
  Significant improvements in various clinical quality measures were observed in all seven practices. Of the 19 specified interventions, 13 were statistically significant at α=0.05 level and 14 met the target proportion. This suggests that the best practice intervention had a significant impact on some of the health care processes in the physician practices.
  
  
  CONCLUSIONS
  The most impactful interventions were those related to face-to-face educational discussions, patient medical chart documentations rather than those pertaining to medication adherence. Improvements in measuring reporting and recording of data at post-intervention were also observed.
authors.affiliation: Medical Director of Health Equity & Quality Services at Highmark, Pittsburgh, Pennsylvania, Rhonda.moore.johnson@highmark.com ; 120 Fifth Avenue, Suite FAP 733, Pittsburgh, PA 15222 ;
authors.forename: Rhonda M
authors.initials: RM
authors.lastname: Johnson
authors.affiliation: Manager, Provider Engagement, Performance & Partnerships at Highmark, Pittsburgh, Pennsylvania, twyla.johnson@highmark.com ; 120 Fifth Avenue, Suite 893, Fifth Avenue Place Pittsburgh, PA 15222-3099; ;
authors.forename: Twyla
authors.initials: T
authors.lastname: Johnson
authors.affiliation: Research Specialist V at the Center for Occupational Biostatistics and Epidemiology, Department of Biostatistics at University of Pittsburgh. scd27@pitt.edu ; A410 Crabtree Hall A411 DeSoto Street, Pittsburgh, PA 15261.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Zimmerman
authors.affiliation: Professor of Biostatistics, Epidemiology and Clinical & Translational Sciences, and Director of the Center for Occupational Biostatistics and Epidemiology at the Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Director, gmarsh@pitt.edu A410 Crabtree Hall 130 DeSoto Street, Pittsburgh, PA 15261 ;
authors.forename: Gary M
authors.initials: GM
authors.lastname: Marsh
authors.affiliation: Highmark Health Equity Quality Consultant; NIH NCI CRCHD K01 grantee; and Adjunct Assistant Professor of Public Health Sciences, and Biobehavioral Health at The Pennsylvania State University, Milton S. Hershey Medical Center, College of Medicine, Hershey, Pennsylvania, 100 Senate Avenue, Suite SP6N Camp Hill, PA 17011.
authors.forename: Oralia
authors.initials: O
authors.lastname: Garcia-Dominic
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D001249:Asthma / Q000208:ethnology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000628:therapy; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000208:ethnology* / Q000628:therapy; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data; D010414:Pennsylvania; D010865:Pilot Projects; D011320:Primary Health Care / Q000191:economics*; D015397:Program Evaluation; D058996:Quality Improvement / Q000706:statistics & numerical data*; D012052:Reimbursement, Incentive; D055815:Young Adult
keywords: BMI and Diabetes; Healthcare Health Disparities; Pay-for-Performance; Primary Care Physicians; Smoking