Canadian researchers report that despite uptake by physicians, a financial incentive wasn't found to alter follow-up after hospital discharge. This lack of effect may be explained by features of the incentive or by extra-physician barriers to follow-up. The report suggests these barriers should be considered by policymakers before introducing similar initiatives. The authors found that $25 premium didn't entice physicians to conduct follow-up visits within two weeks of hospital discharge - a period marked by a high risk of adverse events and omissions of care. The study analyzed surgical and medical patients sent home from the hospital, and assessed an intervention comprised of a supplemental billing code that gave providers a $25 premium for performing an outpatient visit within two weeks of hospital discharge. During the study period, the incentive code was used in 31% of qualifying visits by 51% of qualifying physicians, for a cost of $17.5 million. Researchers found no significant difference in the average monthly rate of outcomes the year before the incentive's introduction (66.5%) vs. the year after (67%). Monthly outcome rates were found to be similar between groups with seven-day physician follow-up (44.9% vs. 44.9%) and the composite outcome (year before, 16.7% vs. year after, 16.9%).
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