Smoking Push

A research, appearing in the current issue of the Archives of Internal Medicine, looked at plans that tie physician pay to the quality of care. The main measure was clinics’ referrals of patients in Minnesota to a tobacco quit line. Scientists compared clinics that were paid bonuses for making such referrals – $5,000 for 50 referrals and $25 for each referral beyond the initial 50 – to clinics that didn’t have a financial motive.

Paying providers of health care to refer patients for help in giving up smoking really makes a difference.

As it found out that the clinics that were in the pay-for-performance program made 1,483 referrals to the giving up line, an average of 11.4% of their patients who were smokers. Those that didn’t have the chance to earn extra money made 441 referrals, an average of 4.2% of their smokers. The scientists, led by Lawrence An of the University of Minnesota, noted some important factors for success beyond cold cash. For one, Minnesota health programs collaborated to make the referral process easy for the clinics. The clinics were also rewarded regardless of what health plan their patients belonged to, meaning that they could make the same recommendation to all smokers.

Blue Cross and Blue Shield of Minnesota, which funded the payments and study to the clinics with money from a tobacco settlement, decided along with a number of other Minnesota health plans to continue with the around smoking stop, although with lower financial awards.