Pay for Performance Has Little Effect on Quality Improvement in NSTEMI Treatment

In programs to raise standards of care, the role of financial incentives remains uncertain.

The Centers for Medicare and Medicaid Services (CMS) pay-for-performance (P4P) initiative provides financial incentives to hospitals that perform well on quality indicators — and disincentives to hospitals that perform poorly. P4P has been met with skepticism, and studies assessing P4P’s effect on care have produced mixed results. In a new analysis, investigators from the CRUSADE National Quality Improvement Initiative Registry compared process and outcomes data on treatment of non–ST-segment-elevation MI (NSTEMI) from 54 hospitals that participated in P4P with similar data from 446 hospitals that did not participate in P4P. A total of 105,383 patients with NSTEMI were included in the analysis.

Use of aspirin and beta-blockers at arrival and…

Reviewing Author

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)