Improving physicians' preventive health care behavior through peer review and financial incentives

Arch Fam Med. 1995 Feb;4(2):165-9. doi: 10.1001/archfami.4.2.165.


We assessed improvement of preventive health care behaviors by physicians in an independent practice association-health maintenance organization. A before-after, 3-year study of a defined cohort measured changes through chart audit, accompanied by peer review, feedback, and financial incentives. Outcome measures consisted of rates of mump-measles-rubella (MMR) immunization, screening for cholesterol levels, and charting adequacy. Offices meeting MMR vaccination standards over 3 years increased from 78% to 96% (P < .05); those meeting standards for screening for cholesterol levels, from 92% to 95%. The average scores for charting adequacy rose from 87% to 92% (P < .05). The percentage of practices not in compliance with a standard of 90% decreased as follows: for MMR vaccination, from 57% to 12%; for screening for cholesterol levels, from 21% to 11%; and for charting adequacy, from 53% to 29% (P < .05).

MeSH terms

  • Cholesterol / blood
  • Feedback
  • Health Maintenance Organizations / standards
  • Health Maintenance Organizations / statistics & numerical data
  • Humans
  • Immunization / statistics & numerical data
  • Medical Audit*
  • Practice Patterns, Physicians'* / economics
  • Practice Patterns, Physicians'* / standards
  • Preventive Health Services / statistics & numerical data*
  • Reimbursement, Incentive*
  • United States


  • Cholesterol