The Impact of Financial Incentives on Quality of Health Care

Milbank Quarterly

Volumn 76, Issue 4, 1998, Pages 649-686

  Dudley, R Adams ^a   Miller, Robert H ^a   Korenbrot, Tamir Y ^a   Luft, Harold S ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

COMPARATIVE STUDY; ECONOMICS; EVALUATION; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HEALTH MAINTENANCE ORGANIZATION; HEALTH SERVICES RESEARCH; HUMAN; MEDICAL FEE; MORBIDITY; PATIENT SATISFACTION; REIMBURSEMENT; REVIEW; RISK ASSESSMENT; STANDARD; STATISTICS; TREATMENT OUTCOME; UNITED STATES;

DELIVERY OF HEALTH CARE; EVALUATION STUDIES; FEE-FOR-SERVICE PLANS; HEALTH MAINTENANCE ORGANIZATIONS; HEALTH SERVICES RESEARCH; HUMANS; MORBIDITY; PATIENT SATISFACTION; QUALITY INDICATORS, HEALTH CARE; QUALITY OF HEALTH CARE; REIMBURSEMENT, INCENTIVE; RISK ADJUSTMENT; TREATMENT OUTCOME; UNITED STATES;

EID: 0032238034     PISSN: 0887378X     EISSN: None     Source Type: Journal    
DOI: 10.1111/1468-0009.00109     Document Type: Article

References (71)

1. Adler, G.S. 1995. Medicare Beneficiaries Rate Their Medical Care: New Data from the MCBS. Health Care Financing Review 16:175-87.
2. Angus, D.C., W.T. Linde-Zwirble, C.A. Sirio, A.J. Rotondi, L. Chelluri, J.R. Lave, and M.R. Pinsky. 1996. The Effect of Managed Care on ICU Length of Stay. Implications for Medicare. Journal of the American Medical Association 276:1075-82.
3. Bernstein, A.B., G.B. Thompson, and L.C Harlan. 1991. Differences in Rates of Cancer Screening by Usual Source of Medical Care. Data from the 1987 National Health Interview Survey. Medical Care 29:196-209.
4. Blumenthal, D. 1996. Quality of Health Care. Part 1: Quality of Care -What Is It? New England Journal of Medicine 335:891-4.
5. Borowsky, S.J., M.K. Davis, C. Goertz, and N. Lurie. 1997. Are All Health Plans Created Equal? The Physician's View. Journal of the American Medical Association 278:917-21.
6. Boyd, J., and L. Kelley. 1996. Health Law 2000: Regulation, Litigation, or Strangulation? Health Affairs 15(3):31-4.
7. Braveman, P., M. Schaaf, S. Egerter, T. Bennett, and W. Schecter. 1994. Insurance-Related Differences in the Risk of Ruptured Appendix. New England Journal of Medicine 331:444-9.
8. Bredfeldt, R.C., M.L. Brewer, and J.A. Junker. 1990. Influences upon Reported Health Promotion by Family Physicians. Family Practice Research Journal 9:85-94.
9. Brook, R.H., E.A. McGlynn, and P.D. Cleary. 1996. Quality of Health Care. Part 2: Measuring Quality of Care. New England Journal of Medicine 335:966-70.
10. Brook, R.H., R.E. Park, M.R. Chassin, D.H. Solomon, J. Keesey, and J. Kosecoff. 1990. Predicting the Appropriate Use of Carotid Endarterectomy, Upper Gastrointestinal Endoscopy, and Coronary Angiography. New England Journal of Medicine 323:1173-7.
11. Burstin H.R., S.R. Lipsitz, and T.A. Brennan. 1992. Socioeconomic Status and Risk for Substandard Medical Care. Journal of the American Medical Association 268:2383-7.
12. Bursztajn, H., and A. Brodsky. 1996. A New Resource for Managing Malpractice Risks in Managed Care. Archives of Internal Medicine 156:2057-63.
13. Cangialose, C.B., S.J. Cary, L.H. Hoffman, and D.J. Ballard. 1997. Impact of Managed Care on Quality of Healthcare: Theory and Evidence. American Journal of Managed Care 3:1153-70.
14. Carey, T.S., J. Garrett, A. Jackman, C. McLaughlin, J. Fryer and D.R. Smucker. 1995. The Outcomes and Costs of Care for Acute Low Back Pain among Patients Seen by Primary Care Practitioners, Chiropractors, and Orthopedic Surgeons. New England Journal of Medicine 333:913-17.
15. Carlisle, D.M., A.L. Siu, E.B. Keeler, et al. 1992. HMO vs Fee-for-Service Care of Older Persons with Acute Myocardial Infarction. American Journal of Public Health 82:1626-30.
16. Coffey, E., I. Moscovice, M. Finch, J.B. Christianson, and N. Lurie. 1995. Capitated Medicaid and the Process of Care of Elderly Hypertensives and Diabetics: Results from a Randomized Trial. American Journal of Medicine 98:531-6.
17. Cole, R.E., S.K. Reed, H.M. Babigian, S.W. Brown, and J. Fray. 1994. A Mental Health Capitation Program: I. Patient Outcomes. Hospital and Community Psychiatry 45:1090-6.
18. Cummings, S.R., M.J. Stein, B. Hansen, R. J. Richard, B. Gerbert, and T.J. Coates. 1989. Smoking Counseling and Preventive Medicine. A Survey of Internists in Private Practices and a Health Maintenance Organization. Archives of Internal Medicine 149:345-9.
19. Enthoven, A.C., and S.J. Singer. 1995. Market-based Reform: What to Regulate and by Whom. Health Affairs 14(1):105-19.
20. Experton, B., R.J. Ozminkowski, L.G. Branch, and Z. Li. 1996. A Comparison by Payor/Provider Type of the Cost of Dying among Frail Older Adults. Journal of the American Geriatrics Society 44:1098-107.
21. Greenfield, S., W. Rogers, M. Mangotich, M.F. Carney, and A.R. Tarlov. 1995. Outcomes of Patients with Hypertension and Non-Insulin Dependent Diabetes Mellitus Treated by Different Systems and Specialties. Results from the Medical Outcomes Study. Journal of the American Medical Association 274:1436-44.
22. Hanchak, N.A., N. Schlackman, and S. Harmon-Weiss. 1996. U.S. Healthcare's Quality-based Compensation Model. Health Care Financing Review 17(3):143-59.
23. Hillman, B.J., C.A. Joseph, M.R. Mabry, J.H. Sunshine, S.D. Kennedy, and M. Noether. 1990. Frequency and Costs of Diagnostic Imaging in Office Practice - A Comparison of Self-Referring and Radiologist-Referring Physicians. New England Journal of Medicine 323:1604-8.
24. Iglehart, J.K. 1997. Listening in on the Duke University Private Sector Conference. New England Journal of Medicine 336:1827-31.
25. Kane, R.L., M. Finch, L. Blewett, Q. Chen, R. Burns, and M. Moskowitz. 1996. Use of Post-Hospital Care by Medicare Patients. Journal of the American Geriatrics Society 44:242-50.
26. Kerr, E.A., R.D. Hays, B.S. Mittman, A.L. Siu, B. Leake, and R.H. Brook. 1997. Primary Care Physicians' Satisfaction with Quality of Care in California Capitated Medical Groups. Journal of the American Medical Association 278:308-12.
27. Langa, K.M., and E.J. Sussman. 1993. The Effect of Cost-Containment Policies on Rates of Coronary Revascularization in California. New England Journal of Medicine 329:1784-9.
28. Lave, J.R., D.G. Ives, N.D. Traven, and L.H. Kuller. 1996. Evaluation of a Health Promotion Demonstration Program for the Rural Elderly. Health Services Research 31:261-81 .
29. Lee-Feldstein, A., H. Anton-Culver, and P.J. Feldstein. 1994. Treatment Differences and Other Prognostic Factors Related to Breast Cancer Survival. Journal of the American Medical Association 271:1163-8.
30. Lohr, K.N., and S.A. Schroeder. 1990. A Strategy for Quality Assurance in Medicare. New England Journal of Medicine 322:707-12.
31. Lubeck, D.P., B.W. Brown, and H.R. Holman. 1985. Chronic Disease and Health System Performance: Care of Osteoarthritis across Three Health Services. Medical Care 23:266-77.
32. Lurie, N., J. Christianson, M. Finch, and I. Moscovice. 1994. The Effects of Capitation on Health and Functional Status of the Medicaid Elderly. Annals of Internal Medicine 120:506-11.
33. Manton, K.G., R. Newcomer, G.R. Lowrimore, J.C. Vertrees, and C. Harrington. 1993. Social/Health Maintenance Organization and Fee-for-Service Health Outcomes Over Time. Health Care Financing Review 15 (winter):173-202.
34. Mark, T., and C. Mueller. 1996. Access to Care in HMOs and Traditional Insurance Plans. Health Affairs 15(winter):81-7.
35. Mechanic, D. 1997. Managed Care as a Target of Distrust. Journal of the American Medical Association 277:1810-1.
36. Merkel, P.A., and C. Caputo. 1994. Evaluation of a Simple Office-based Strategy for Increasing Influenza Vaccine Administration and Effects of Deferring Reimbursement Plans on the Patient Acceptance Rate. Journal of General Internal Medicine 4 (December):679-83.
37. Miller, N.A. 1992. An Evaluation of Substance Misuse Treatment Providers Used by an Employee Assistance Program. International Journal of the Addictions 27:533-59.
38. Miller, R.H., and H.S. Luft. 1994. Managed Care Plan Performance since 1980: A Literature Analysis. Journal of the American Medical Association 271:1512-19.
39. _. 1997. Does Managed Care Lead to Better or Worse Quality of Care? Health Affairs 16(5):7-25.
40. Mitchell, J.M., and J.H. Sunshine. 1992. Consequences of Physicians' Ownership of Health Care Facilities - Joint Ventures in Radiation Therapy. New England Journal of Medicine 327:1497-501.
41. Mustin, H.D., V.L. Holt, and F.A. Connell. 1994. Adequacy of Well-Child Care and Immunizations in US Infants Born in 1988. Journal of the American Medical Association 272:1111-15.
42. National Committee for Quality Assurance. 1996. Effectiveness of Care, Health Plan Employer Data and Information Set (HEDIS 3.0). Washington, D.C.
43. Newhouse, J.P., M.B. Buntin, and J.D. Chapman. 1997. Risk Adjustment and Medicare: Taking a Closer Look. Health Affairs 16(5): 26-43.
44. O'Toole, S.J., H.L. Karamanoukian, J.E. Allen, et al. 1996. Insurance-Related Differences in the Presentation of Pediatric Appendicitis. Journal of Pediatric Surgery 31:1032-4.
45. Pallak, M.S., N.A. Cummings, H. Dörken, and C.J. Henke. 1994. Medical Costs, Medicaid, and Managed Mental Health Treatment: The Hawaii Study. Managed Care Quarterly 2(2):64-70
46. Phibbs, C.S., J.M. Bronstein, E. Buxton, and R.H. Phibbs. 1996. The Effects of Patient Volume and Level of Care at the Hospital of Birth on Neonatal Mortality. Journal of the American Medical Association 276:1054-9.
47. Preston, J.A., and S.M. Retchin. 1991. The Management of Geriatric Hypertension in Health Maintenance Organizations. Journal of the American Geriatrics Society 39:683-90.
48. Retchin, S..M., and B. Brown. 1990a. The Quality of Ambulatory Care in Medicare Health Maintenance Organizations. American Journal of Public Health 80:411-15.
49. _. 1990b. Management of Colorectal Cancer in Medicare Health Maintenance Organizations. Journal of General Internal Medicine 5:110-14.
50. _. 1991. Elderly Patients with Congestive Heart Failure Under Prepaid Care. American Journal of Medicine 90:236-42.
51. Retchin, S.M., R.S. Brown, S.J. Yeh, D. Chu, and L. Moreno. 1997. Outcomes of Stroke Patients in Medicare Fee for Service and Managed Care. Journal of the American Medical Association 278: 119-24.
52. Retchin, S.M., D.G. Clement, L.F. Rossiter, B. Brown, R. Brown, and L. Nelson. 1992. How the Elderly Fare in HMOs: Outcomes from the Medicare Competition Demonstration. Health Services Research 27:651-70.
53. Retchin, S.M., and J. Preston. 1991. Effects of Cost Containment on the Care of Elderly Diabetics. Archives of Internal Medicine 151:2244-8.
54. Riley, G.F., A.L. Potosky, J.D. Lubitz, and M.L. Brown. 1994. Stage of Cancer at Diagnosis for Medicare HMO and Fee-for-Service Enrollees. American Journal of Public Health 84:1598-604.
55. Rossiter, L.F., K. Langwell, T.T. Wan, and M. Rivnyak. 1989. Patient Satisfaction among Elderly Enrollees and Disenrollees in Medicare Health Maintenance Organizations. Results from the National Medicare Competition Evaluation. Journal of the American Medical Association 262:57-63.
56. Rubin, H.R., B. Gandek, W.H. Rogers, M. Kosinski, C.A. McHorney, and J.E. Ware. 1993. Patients' Ratings of Outpatient Visits in Different Practice Settings. Results from the Medical Outcomes Study. Journal of the American Medical Association 270:835-40.
57. Safran, D.G., A.R. Tarlov, and W.H. Rogers. 1994. Primary Care Performance in Fee-for-Service and Prepaid Health Care Systems. Journal of the American Medical Association 271:1579-86.
58. Schulman, K.A., L.E. Rubenstein, D.J. Seils, M. Harris, J. Hadley, and J.J. Escarce. 1997. Quality Assessment in Contracting for Tertiary Care Services by HMOs: A Case Study of Three Markets. Joint Commission Journal on Quality Improvement 23(2):117-27.
59. Shaughnessy, P.W., R.E. Schlenker, and D.F. Hittle. 1994. Home Health Care Outcomes Under Capitated and Fee-for-Service Payment. Health Care Financing Review 16(fall):187-221.
60. Sisk, J.E., S.A. Gorman, A.L. Reisinger, S.A. Glied, W.H. DuMouchel, and M.M. Hynes. 1996. Evaluation of Medicaid Managed Care. Satisfaction, Access and Use. Journal of the American Medical Association 276:50-5.
61. Starr, A., A.P. Furnary, G.L. Grunkemeier, G.W He, and A. Ahmad. 1996. Surgery for Acquired Heart Disease. Journal of Thoracic and Cardiovascular Surgery 111:708-16.
62. Udvarhelyi, I.S., K. Jennison, R.S. Phillips, and A.M. Epstein. 1991. Comparison of the Quality of Ambulatory Care for Fee-for-Service and Prepaid Patients. Annals of Internal Medicine 327:424-9.
63. Vernon, S.W., J.I. Hughes, V.M. Heckel, and G.L. Jackson. 1992. Quality of Care for Colorectal Cancer in a Fee-for-Service and Health Maintenance Organization Practice. Cancer 69:2418-25.
64. Ware, J.E., M.S. Bayliss, W.H. Rogers, M. Kosinski, and A.R. Tarlov. 1996. Differences in 4-Year Health Outcomes for Elderly and Poor, Chronically Ill Patients Treated in HMO and Fee-for-Service Systems. Results from the Medical Outcomes Study. Journal of the American Medical Association 276:1039-47.
65. Wells, K.B., R.H. Hays, M.A. Burnam, W. Rogers, S. Greenfield, and J.E. Ware. 1989. Detection of Depressive Disorder for Patients Receiving Prepaid or Fee-for-Service Care: Results from the Medical Outcomes Study. Journal of the American Medical Association 262:3298-302.
66. Wells, K.B., W. Katon, B. Rogers, and P. Camp. 1994. Use of Minor Tranquilizers and Antidepressant Medications by Depressed Outpatients: Results From the Medical Outcomes Study. American Journal of Psychiatry 151:694-700.
67. Yelin, E.H., L.A. Criswell, and P.G. Feigenbaum. 1996. Health Care Utilization and Outcomes among Persons with Rheumatoid Arthritis in Fee-for-Service and Prepaid Group Practice Settings. Journal of the American Medical Association 276:1048-53.
68. Yelin, E.H., M.A. Shern, and W.V. Epstein. 1986. Health Outcomes for a Chronic Disease in Prepaid Group Practice and Fee-for-Service Settings. Medical Care 24:236-46.
69. Yergan, J., A.B. Flood, P. Diehr, and J.P. LoGerfo. 1988. Relationship between Patient Source of Payment and the Intensity of Hospital Services. Medical Care 26:1111-4.
70. Young, G.J., and B.B. Cohen. 1991. Inequities in Hospital Care: The Massachusetts Experience. Inquiry 28:255-62.
71. _. 1992. The Process and Outcome of Hospital Care for Medicaid Versus Privately Insured Hospital Patients. Inquiry 29:366-71.