IU study: Money matters to docs

Think doctors and hospitals aren’t influenced by money? Think again.

Patients seen at private facilities reimbursed by Medicare were 5.5 times as likely to receive routine cataract surgery than
patients at poorly funded Veterans Affairs facilities, according to a study whose lead author was Dr. Dustin French, a professor
at the Indiana University School of Medicine and an investigator at the Indianapolis-based Regenstrief Institute Inc.

A press release about the study from IU and Regenstrief called the results “a strong indication” that physicians
or their medical facility or both “may be responsive to financial incentives.”

In English, that means they know where their bread is buttered. The study reinforces wide criticisms of doctors that they
order more procedures and more tests because insurance programs like Medicare and even private plans pay them for volume of
services, not quality or outcomes.

The health reform bill signed into law Tuesday by President Obama includes pilot programs designed to reward doctors and
hospitals for quality instead of quantity. But many health care insiders have criticized those programs as being too modest
to make a significant difference in doctor and hospital behavior.

Findings from the large, eight-year study were published in the March 2010 issue of the American Journal of Medical Quality.
French’s two co-authors were from the University of South Florida and the Department of Veterans Affairs.

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