Financial breaks encourage adoption of cardiovascular guidelines

07/29/04

A little incentive can go a long way in encouraging hospitals to adopt treatment standards that can keep cardiovascular patients from making repeat hospital visits, new research suggests.

Ten of 13 Hawaiian hospitals studied earned $354,883 for implementing specific parts of a cardiovascular guidelines program established by the American Heart Association and the American College of Cardiology, according to the research published in the American Journal of Managed Care.

The incentives money was paid as part of a more comprehensive hospital "pay-for-performance" program called the Hospital Quality and Service Recognition Program, implemented by the commercial insurer Hawaii Medical Service Association, Blue Cross Blue Shield of Hawaii.

"This finding suggests that the presence of financial incentives tied to the steps of participation may play an important role in speeding the adoption of innovative programs," say John T.Berthiaume, M.D., of the Hawaii Medical Service Association and colleagues.

The hospitals earned the money by accumulating "points" for building a hospital team trained in the guidelines, attending regular workshops on the recommended treatments, submitting patient data to a special database and using preprinted doctors' orders and protocols.

Hospitals could also earn points by making sure that at least 85 percent of eligible cardiovascular patients received recommended follow-up care, including the prescription of aspirin, beta-blockers, ACE inhibitors, cholesterol-lowering drugs and counseling to quit smoking. Four of the 13 hospitals reached the 85 percent goal.

Participating hospitals also received reimbursement for half the cost of the data collection and management tool used by the guidelines program.

Most of the hospital administrators said the extra money was used to boost staff salaries and cover the costs of attending meetings and workshops on the guidelines.

The researchers have not confirmed whether the changes have reduced cardiovascular problems among hospitalized patients, but "a significant and measurable improvement in secondary prevention of coronary artery disease in Hawaii is anticipated" based on results from similar studies, Berthiaume says.

Source: Eurekalert & others

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