Paying For Performance In Primary Care: Potential Impact On Practices And Disparities

Performance-based payments are increasingly common in primary care. With persistent disparities in the quality of care that different populations receive, however, such payments may steer new resources away from the care of racial and ethnic minorities and people of low socioeconomic status. We simu...

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Bibliographic Details
Published in:Health Affairs 2010-05, Vol.29 (5), p.926-932
Main Authors: Friedberg, Mark W., Safran, Dana Gelb, Coltin, Kathryn, Dresser, Marguerite, Schneider, Eric C.
Format: Article
Language:English
Subjects:
At risk populations
Censuses
Citizenship
Demographics
Design specifications
Ethnicity
Health care policy
Health facilities
Medical practices
Medicare
Minority & ethnic groups
Patients
Pay for performance
Payments
Physicians
Primary care
Quality of care
Race
Simulation
Sociodemographics
Socioeconomic factors
Socioeconomic status
Socioeconomics
Studies
Variables
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Summary:Performance-based payments are increasingly common in primary care. With persistent disparities in the quality of care that different populations receive, however, such payments may steer new resources away from the care of racial and ethnic minorities and people of low socioeconomic status. We simulated performance-based payments to Massachusetts practices serving higher and lower shares of patients from these vulnerable communities in Massachusetts. Typical practices serving higher shares of vulnerable populations would receive less per practice compared to others, by estimated amounts of more than $7,000. These findings suggest that pay-for-performance programs should monitor and address the potential impact of performance-based payments on health care disparities. [PUBLICATION ABSTRACT]
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2009.0985