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J Racial Ethn Health Disparities. 2015 Mar;2(1):139-48. doi: 10.1007/s40615-014-0057-8.

Outcomes of a Seven Practice Pilot in a Pay-For-Performance (P4P)-Based Program in Pennsylvania.

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Medical Director of Health Equity & Quality Services at Highmark, Pittsburgh, Pennsylvania, ; 120 Fifth Avenue, Suite FAP 733, Pittsburgh, PA 15222 ;
Manager, Provider Engagement, Performance & Partnerships at Highmark, Pittsburgh, Pennsylvania, ; 120 Fifth Avenue, Suite 893, Fifth Avenue Place Pittsburgh, PA 15222-3099; ;
Research Specialist V at the Center for Occupational Biostatistics and Epidemiology, Department of Biostatistics at University of Pittsburgh. ; A410 Crabtree Hall A411 DeSoto Street, Pittsburgh, PA 15261.
Professor of Biostatistics, Epidemiology and Clinical & Translational Sciences, and Director of the Center for Occupational Biostatistics and Epidemiology at the Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Director, A410 Crabtree Hall 130 DeSoto Street, Pittsburgh, PA 15261 ;
Highmark Health Equity Quality Consultant; NIH NCI CRCHD K01 grantee; and Adjunct Assistant Professor of Public Health Sciences, and Biobehavioral Health at The Pennsylvania State University, Milton S. Hershey Medical Center, College of Medicine, Hershey, Pennsylvania, 100 Senate Avenue, Suite SP6N Camp Hill, PA 17011.



The objective of this study was to examine how targeted six-month interventions impacted Best Practice/Patient Outcomes for minority patients receiving primary care in physician practices participating in a pay-for-performance (P4P) program.


P4P Practices were invited to participate in a pilot intervention study designed to improve care for minority patients with hypertension, diabetes or pediatric asthma. Patient medical records were reviewed to assess how the interventions impacted (n=7 practices): Body mass index, diet and exercise, smoking, compliance with visits as recommended, blood pressure, sodium intake and weight management counseling, medication reconciliation, HbA1c testing, annual lipid profile, and anti-inflammatory medications.


Significant improvements in various clinical quality measures were observed in all seven practices. Of the 19 specified interventions, 13 were statistically significant at α=0.05 level and 14 met the target proportion. This suggests that the best practice intervention had a significant impact on some of the health care processes in the physician practices.


The most impactful interventions were those related to face-to-face educational discussions, patient medical chart documentations rather than those pertaining to medication adherence. Improvements in measuring reporting and recording of data at post-intervention were also observed.


BMI and Diabetes; Healthcare Health Disparities; Pay-for-Performance; Primary Care Physicians; Smoking

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