Financial Incentives Associated With ACO Participation and Meaningful Use

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Approximately 64%, 45%, and 2% of physicians were exposed to financial incentives, public reporting, and practice revenue from financial incentives, respectively.
Approximately 64%, 45%, and 2% of physicians were exposed to financial incentives, public reporting, and practice revenue from financial incentives, respectively.

Prior exposure to financial incentives and public reporting is significantly associated with physician participation in Medicare Accountable Care Organization (ACO) programs and Meaningful Use, according to findings published in Health Services Research.

Researchers obtained physician practice data from the National Survey of Physician Organizations 3 ([NSPO3]; n=907,538) as well as the Medicare 2013 Physician Compare National Provider-Level National File (n=907,538) to measure participation in Physician Compare and Meaningful Use.

The investigators sought to determine whether "greater experience and success with performance incentives among physician practices are related to increased participation in Medicare's voluntary value-based payment reforms."

According to the findings, approximately 64%, 45%, and 2% of physicians were exposed to financial incentives, public reporting, and practice revenue from financial incentives, respectively. There was an average increase by 0.9 percentage points in the likelihood of physicians participating in ACO programs for every percentage increase in financial incentives (<.001). 

For every percentage-point increase in financial incentives, there was also an average increase by 0.8 percentage points in the likelihood of physician participation in Meaningful Use (<.001).

The study's investigators caution against generalizing the report's findings across the population. According to the authors, "the influence of performance incentives on value-based reforms is likely context dependent and depends on the exact nature of the incentives."

Additionally, the cross-sectional study design, which limits causal inference, represents another limitation to this study.

Investigators suggest that to promote value-based payment on a broader scale, Medicare "must complement financial incentives with additional efforts to address the needs of practices with less experience with such incentives."

Reference

Markovitz AA, Ramsay PP, Shortell SM, Ryan AM. Financial incentives and physician practice participation in Medicare's value-based reforms. Health Serv Res. 2017 Jul 26. doi: 10.1111/1475-6773.12743. [Epub ahead of print]

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