Incentivizing the outcome: Determining the effectiveness of an incentive program utilizing a health information exchange

BACKGROUND: Both Health Information Technology (HIT) and Pay-for-Performance (P4P) incentives have been shown to be modestly successful in improving the quality of healthcare. Less is known about whether these strategies are effective for providers who serve vulnerable populations at Federally Qualified Health Centers (FQHCs). OBJECTIVE: The goal of this study is to examine the effectiveness of a HIT-P4P intervention that rewarded providers for reducing emergency room visits, hospitalizations, and diabetes levels among a high-risk group of minority patients. In this study, teams of clinical staff had the ability to track patient data on performance measures via a health information exchange. METHODS: The sample included predominantly low-income Asian Americans, Native Hawaiians, and Other Pacific Islanders with either diabetes or cardiovascular disease and a psychosocial condition. Emergency room visits, hospitalizations, and diabetes data were collected from a health information exchange for thirteen FQHCs in Hawaii. RESULTS: Preliminary findings show that the four FQHCs who received P4P incentives showed greater improvement on measures compared to a comparison group of nine FQHCs who did not receive incentives. Furthermore, FQHCs in the intervention group who regularly utilized the health information exchange to track patient data scored better on performance measures than FQHCs who did not. Final findings will be shared during the presentation of this study. DISCUSSION: Improving HIT resources and changing the incentive structure for FQHCs can be effective at reducing emergency room visits, hospitalizations, and diabetes for high-risk minority patients.