British Medical Journal: The Impact Of Removing Financial Incentives From Clinical Quality Indicators: Longitudinal Analysis Of Four Kaiser Permanente Indicators – The researchers found the removal of pay-for-performance incentives "was associated with a decrease in performance of about 3% per year on average for screening for diabetic retinopathy and about 1.6% per year for cervical cancer screening" (Lester et al., 5/11). More details about the study and related news coverage are in the May 12 Morning Report.

Mathematica Policy Research: Basing Healthcare On Empirical Evidence --  This brief (.pdf) examines the projects, by various federal, state and private-sector organizations (using federal stimulus funds) that aim to foster evidence-based practice. "As major buyers of health care, states can play a prominent role in promoting evidence-based practice and minimizing burden on providers. In particular, as Medicare focuses increasingly on incentives for evidence-based practice when comparative effectiveness research strongly supports it, state policymakers can build consistent incentives in Medicaid and other state-administered programs and health plans, and also engage private insurers in these efforts. By coordinating these efforts across payers, the states can play a pivotal role in building consistent incentives to improve the quality and efficiency of care—a goal of all stakeholders in health care reform" (Bernstein, Chollet, and Peterson, May 2010).

Additional briefs in the series look at the benefits and cost-effectiveness of preventive health services and the relationship between health insurance and health outcomes.

Commonwealth Fund: Blueprint For The Dissemination Of Evidence-Based Practices In Health Care – "Despite the substantial literature on evidence-based clinical care practices that have proven effective in controlled environments and trials, a major challenge for health care systems has been to spread these advances broadly and rapidly," write the authors, who propose a blueprint for dissemination of best practices by national quality improvement campaigns. The eight key strategies to success include the need to: "highlight the evidence base and relative simplicity of recommended practices; ... develop practical implementation tools and guides for key stakeholder groups; ... create networks to foster learning opportunities; and ... incorporate monitoring and evaluation of milestones and goals" (Yuan, Nembhard, Stern et al., 5/4).

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