Can Dual Patient–Physician Incentives Improve Outcomes?

Sharing incentives between both physicians and patients improved outcomes in patients trying to reduce low-density lipoprotein cholesterol (LDL-C), according to recent study.

While financial incentives given to both physicians and patients are increasing in their frequency of use, their effectiveness has not been well established.

To further explore this issue, researchers conducted a 4-group cluster randomized clinical trial involving a 12-month intervention of 340 participating primary care physicians (PCPs) and 1502 patients. Patients were eligible if they had a 10-year Framingham Risk Score (FRS) of 20% or higher, coronary artery disease equivalents with LDL-C levels of 120 mg/dL or greater, or an FRS of 10% to 20% with LDL-C levels of 140 mg/dL or greater.
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Overall, participants in the shared incentives group achieved an average reduction in LDL-C of 33.6 mg/dL compared with those in the physician incentives group (27.9 mg/dL) and those in the patients incentives group (25.1 mg/dL). Control patients achieved a reduction of 25.1 mg/dL.

“In primary care practices, shared financial incentives for physicians and patients, but not incentives to physicians or patients alone, resulted in a statistically significant difference in reduction of LDL-C levels at 12 months,” they concluded.

“This reduction was modest, however, and further information is needed to understand whether this approach represents good value.”

—Michael Potts

Reference:

Asch DA, Troxel AB, Stewart WF. Effect of financial incentives to physicians, patients, or both on lipid levels. JAMA. 2015;314(18):1926-1935.