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

Abstract

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.