Eli's Rehab Report

New York, N.Y.--If you're waiting for Medicare to move forward with payment incentives for physician performance--and eventually for therapist outcomes--you may find yourself waiting longer.

Why: A recent Medicare pilot project published in the June 1 Journal of American Medical Association indicated that pay-for-performance (P4P) efforts may not be all they're cracked up to be, according to a June 6 article in the Wall Street Journal.

The facts: Researchers at Duke University examined heart attack treatments at 500 hospitals and found that hospitals receiving financial incentives to follow treatment guidelines didn't improve their practices significantly more than hospitals that got no financial benefit, the WSJ said. Researchers noted some slightly higher rates of improvement for certain target areas, but not enough to make a difference.

Explanation: Perhaps financial penalties for not complying weren't sufficient, the Journal suggested. "One read on this is that the carrots have to be bigger," said Duke cardiologist Eric D. Peterson, author of the Journal article. Likewise, hospital officials involved in the pilot project said last winter in a conference call with WSJ that "financial incentives were small relative to their budgets."

How does this apply to rehab? What starts in the physician community generally trickles down to the rehab community in some form, and therapists do have P4P on their radar.