Dataset Information

Has pay-for-performance decreased access for minority patients?

ABSTRACT:

Objective

To examine whether the CMS and Premier Inc. Hospital Quality Incentive Demonstration (PHQID), a hospital-based pay-for-performance (P4P) and public quality reporting program, caused participating hospitals (1) to avoid treating minority patients diagnosed with acute myocardial infarction (AMI), heart failure, and pneumonia and (2) to avoid providing coronary artery bypass graft (CABG) to minority patients diagnosed with AMI.

Data sources

One hundred percent Medicare inpatient claims, denominator files, and provider of service files from 2000 to 2006.

Study design

We test for differences in the conditional probability of receiving care at PHQID hospitals for AMI, heart failure, and pneumonia before and after implementation of the PHQID between white and minority patients. We also test for differences in the conditional probability that white and minority patients diagnosed with AMI receive CABG in hospitals participating, and not participating, in the PHQID before and after the implementation of the PHQID.

Data extraction methods

Data were obtained from CMS.

Principal findings

We find little evidence that the PHQID reduced access for minority patients: only "Other Race" beneficiaries had a significant reduction in adjusted admissions to PHQID hospitals in the postperiod, and only for AMI. Only marginally significant ( p<.10) evidence of a reduction in CABG was found, also occurring for Other Race beneficiaries.

Conclusions

Despite minimal evidence of minority patient avoidance in the PHQID, monitoring of avoidance should continue for P4P programs.

SUBMITTER: Ryan AM

PROVIDER: S-EPMC2813434 | biostudies-literature | 2010 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Has pay-for-performance decreased access for minority patients?

Ryan Andrew M AM

Health services research 20091015 1

<h4>Objective</h4>To examine whether the CMS and Premier Inc. Hospital Quality Incentive Demonstration (PHQID), a hospital-based pay-for-performance (P4P) and public quality reporting program, caused participating hospitals (1) to avoid treating minority patients diagnosed with acute myocardial infarction (AMI), heart failure, and pneumonia and (2) to avoid providing coronary artery bypass graft (CABG) to minority patients diagnosed with AMI.<h4>Data sources</h4>One hundred percent Medicare inpa ...[more]

PMID: 19840137

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Dataset Information

Has pay-for-performance decreased access for minority patients?

Objective

Data sources

Study design

Data extraction methods

Principal findings

Conclusions

Publications

Has pay-for-performance decreased access for minority patients?

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