Beginning this fall, new health care rules mandate Medicare pay hospitals based on the quality of care provided. Studies of so-called "pay for performance" health care outcomes indicate mixed results, but one Bloomington-based study of therapists who treat teen drug users shows the model is effective. Bryan Garner, a research scientist with Chestnut Health Systems, led a team of researchers who studied pay incentives handed out to therapists treating teen drug users at 29 community-based providers in the U. S. Garner says modest pay incentives led to dramatic increases in care quality.
"Anywhere from 2% to 7% of their salary, but increase the quality with which they delivered the therapy by about 170%."
Garner say the average salary for a teen drug therapist is about $35,000 and the average age is around 40. Therapists were given bonuses of $200 per patient if they demonstrated they had used a range of treatment tools over a few months. They were paid $50 per month is they showed their overall performance was on par with guidelines of the program. He says the study shows workers given added incentives will follow through.
"Most of the people who are in the field are very dedicated and caring and that's why they are in the field. They are not in it for the money, but when you are able to offer them incentives to do something to increase their behavior, I think they're like most people and they're motivated by it."
Garner says there is evidence patients improved, although not enough providers followed through to make the findings conclusive. The Chestnut study is believed to be the most exhaustive done on the impact of pay for performance in the area of teen drug treatment.
Starting October 1, Medicare will implement the "value-based" system, which uses certain quality measures to determine payment amounts to hospitals. That same model will be phased in for Medicare payments to skilled nursing facilites, home-health agencies and ambulatory surgical centers.
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