Dr. Jan Blustein of New York University, Joel S. Weissman of the Mongan Institute for Health Policy at Massachusetts General Hospital and Harvard Medical School, Andrew M. Ryan of Weill Cornell Medical College and colleagues said Massachusetts' innovative use of "pay-for-performance" bonuses -- hospitals that performed well on specified measures were eligible to receive substantial bonuses -- tried to reduce racial and ethnic disparities in Medicaid patients.
However, the study found no evidence of racial and ethnic disparities at any of the state's 66 acute-care hospitals.
The study, published in Health Affairs, found racial and ethnic inequities for disadvantaged patients may well exist, but the "pay-for-performance" approach -- used to improve quality of care -- proved unsuited to the task of identifying healthcare disparities or their severity, at least in the first years of the program in Massachusetts.
The study said the clinical conditions tracked in the program did not bring to light any significant hospital racial and ethnic disparities, but the hospitals' patient population was not sufficiently diverse to allow the approach to succeed.
The researchers suggest a more effective way to reduce racial and ethnic inequities may be to focus on hospitals that serve minority populations or to examine barriers to health and healthcare rooted in causes "beyond hospital walls."
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