Boston-based Massachusetts General Hospital (MGH) has reached goals related to the adoption of electronic health technology, thanks to a program that incentivizes salaried physicians who achieve specific quality improvement targets.
The results of the first six years of this program were outlined in a recent issue of Health Affairs by the Massachusetts General Physicians Organization (MGPO). MGPO employs more than 98 percent of the physicians on the MGH staff and is a part of Partners Community Healthcare Inc. (PCHI), which works within the Partners Healthcare System. Unlike other pay-for-performance contracts that connected providers with payer claims data, the MGPO Quality Incentive Program focuses on clinical priorities.
"Incentive programs like this – which can help organizations focus the attention of busy clinicians on tasks that help deliver better, more cost-effective care – are very valuable at a time when the health care system is transitioning from fee-for-service to new payment models," Timothy Ferris, M.D., MGPO medical director and a co-author of the report, said in a statement. "One of the ways this differs from traditional pay-for-performance programs is that it was designed by physicians for physicians, who determined what the goals and priorities were."
This program is based on a system used by Medicare and other payers to calculate physician reimbursement, participants are categorized as having high, medium or low levels of clinical activity. It sets specific quality improvement goals for six-month terms, with three different measures and performance targets for each term. Some measures continue over several terms, with increasing targets for succeeding terms. For example, measures related to adoption of an electronic health record (EHR) started with attending training sessions in the system and eventually led to required incorporation of final notes into the system.
Along with the consistent use of the EHR, the program also focused on increasing use of an electronic prescription system, preparation for Joint Commission on the Accreditation of Healthcare Organization reviews and implementation of its recommendations, and improved communication with patients. It also included several departmental goals based on where the the physician worked.