A pay-for-performance (PFP) program implemented at one of the nation's largest general hospitals appeared to have a marked effect on expediting final radiology report turnaround times (RTAT), improving patient care, according to a study in the September issue of the American Journal of Roentgenology (www.ajronline.org).
One increasingly popular trend, used both by the Centers for Medicaid and Medicare Services and by third-party payers, attempts to address variation in quality and performance through the use of PFP programs. Individuals or organizations entering PFP agreements are essentially compensated through one of two mechanisms: a straight bonus that rewards providers with additional payments for achieving stipulated performance targets or placement of a percentage of contracted provider revenue that is directly at risk if these targets are not met.
At Massachusetts General Hospital and Harvard Medical School, in Boston, MA, a radiology PFP program was used to assess its impact on RTAT for all departmental reports from 11 subspecialty divisions. Study periods were 3 months before (baseline period) and immediately after (immediate period) the introduction of the program and 2 years later after the program had terminated (post period).
Three RTAT components were evaluated for individual radiologists and for each radiology division: examination completion (C) to final signature (F), C to preliminary signature (P), and P to F. "Mean C-F, C-P, and P-F for all reports decreased significantly from baseline to immediate to post period, with the largest effect on the P-F component," said Giles W.L. Boland, MD, lead author of the study. RTAT decreased by approximately two-thirds (62 percent) between the baseline and post period.
"Rapid completion and ready availability of final radiology reports is considered an essential and important clinical quality metric. PFP incentives designed to motivate academic radiologists to alter their behavior and perform expeditious finalized signature of preliminary reports appear to be successful," said Boland.
This study appears in the September issue of the American Journal of Roentgenology. For a copy of the full study or to request an interview with Dr. Boland, please contact Heather Curry via email at hcurry@acr-arrs.org or at 703-390-9822.
About ARRS
The American Roentgen Ray Society (ARRS) was founded in 1900 and is the oldest radiology society in the United States. Its monthly journal, the American Journal of Roentgenology, began publication in 1906. Radiologists from all over the world attend the ARRS annual meeting to participate in instructional courses, scientific paper presentations and scientific and commercial exhibits related to the field of radiology. The Society is named after the first Nobel Laureate in Physics, Wilhelm Röentgen, who discovered the x-ray in 1895.
Journal
American Journal of Roentgenology