LA Times: Financial incentives prompt doctors to step up care for patients


Doctor financial incentives studyDoctors paid more attention to their patients’ blood pressure and worked harder to adjust their medications when they were offered financial incentives, a study found. (Joe Raedle / Getty Images)
By Karen Kaplan

How do you get doctors to do a better job of controlling their patients’ high blood pressure? Pay them, according to the results of an unusual clinical trial.

For a typical doctor treating 1,000 patients for hypertension, extra payments of $1,648 were enough to get blood pressure under control – or at least get doctors to prescribe the right drugs and recommend the right lifestyle changes – for 84 additional patients. Those payments (distributed over 20 months) amounted to about 1.6% of the doctor’s annual salary.

It may not sound like much, but apparently it was enough to make a difference. When the clinical trial was over and the payments ended, doctors stopped making the extra effort to control their patients’ blood pressure and things pretty much went back to the way they were before the experiment began. The trial results were published in Wednesday’s edition of the Journal of the American Medical Assn.

The researchers who set up the trial were careful to point out that the financial incentives they offered weren’t meant to “coerce” doctors to pay more attention to their patients with hypertension. Rather, they hoped the money would help them overcome “clinical inertia” and “increase their interest in” managing their patients’ blood pressure, according to the study.

The research team recruited doctors from 12 Veterans Affairs outpatient clinics to test the power of financial incentives. They focused on high blood pressure because it’s a common chronic condition that requires doctors to monitor patients carefully and communicate with them effectively. Even modest improvements in blood pressure translate into fewer cases of coronary artery disease, congestive heart failure, kidney failure, stroke and other health problems.

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