Nonfinancial Incentives for Quality
A Policy Statement From the American Heart Association
The American Heart Association (AHA) and its division, the American Stroke Association, are dedicated to improving the quality of care available to patients who have or are at risk of acquiring cardiovascular diseases, including stroke. Heart disease, stroke, and other cardiovascular diseases remain the No. 1 killer in the United States and a leading cause of permanent disability.1 Approximately 71 million Americans have some form of these diseases.1 In 2006, cardiovascular diseases will cost this nation an estimated $403 billion in medical expenses and lost productivity.1 The AHA is committed to reducing cardiovascular disease by improving the quality of care in the United States, ensuring that this care is patient-centered and of the highest quality and that it ultimately improves patient outcomes.
Earlier this year, the AHA published the statement Payment for Quality: Guiding Principles and Recommendations2 in response to increased interest by healthcare professionals, policy makers, purchasers, and consumers to use financial incentive programs to realign payment for health care and improve the quality of care delivered. Financial incentives involve the direct linkage of financial remuneration with clinical performance, an approach that has been termed “pay for performance,” “pay for value,” or “pay for quality.” Yet, much remains unknown about the effectiveness of the use of financial incentives as a payment strategy and the overall benefit conferred to patients. For this reason, the AHA decided to craft 4 principles to guide the structure and metrics used in pay-for-quality programs and identified at least 6 areas that required additional research to serve as criteria that should be considered when designing and evaluating pay-for-quality programs.2
This second policy statement focuses on the use of nonfinancial incentives alone or in tandem with pay-for-quality programs. Nonfinancial incentives (NFIs) may include but are not limited to provider profiling in …