Hospital Executives' Perspectives on Pay-for-Performance and Racial/Ethnic Disparities in Care

Published In: Medical Care Research and Review, v. 67, no. 5, Oct. 2010, p. 574-589

Posted on RAND.org on October 01, 2010

by Robin M. Weinick, Alyna T Chien, Meredith B. Rosenthal, Steffanie J Bristol, Jessica Salamon

Read More

Access further information on this document at mcr.sagepub.com

This article was published outside of RAND. The full text of the article can be found at the link above.

With increasing attention paid to reducing racial/ethnic disparities in care and the growth of pay-for-performance programs, policy makers and payers are considering the use of such incentive mechanisms to target disparities reduction. This article describes the results of qualitative interviews with hospital executives to assess the potential impact that such programs would have on hospitals and their minority patients. The authors find that executives have significant concerns regarding funding mechanisms and implementation costs, financial risks for safety net hospitals, and resource constraints, as well as how such programs can be used to create incentives to care for minority patients. The findings suggest that payers should be hesitant to use pay-for-performance as a mechanism for reducing disparities until a wide variety of concerns about the design of such programs can be addressed.

This report is part of the RAND Corporation external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.