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American Journal of Public Health, Vol. 88, Issue 11 1699-1701, Copyright © 1998 by American Public Health Association

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Physician financial incentives and feedback: failure to increase cancer screening in Medicaid managed care.

A L Hillman, K Ripley, N Goldfarb, I Nuamah, J Weiner and E Lusk

University of Pennsylvania, Philadelphia, USA.

OBJECTIVES: A randomized controlled trial evaluated the impact of feedback and financial incentives on physician compliance with cancer screening guidelines for women 50 years of age and older in a Medicaid health maintenance organization (HMO). METHODS: Half of 52 primary care sites received the intervention, which included written feedback and a financial bonus. Mammography, breast exam, colorectal screening, and Pap testing compliance rates were evaluated. RESULTS: From 1993 to 1995, screening rates doubled overall (from 24% to 50%), with no significant differences between intervention and control group sites. CONCLUSIONS: Financial incentives and feedback did not improve physician compliance with cancer screening guidelines in a Medicaid HMO.




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