Physician financial incentives and feedback: failure to increase cancer screening in Medicaid managed care

Am J Public Health. 1998 Nov;88(11):1699-701. doi: 10.2105/ajph.88.11.1699.


Objectives: A randomized controlled trial evaluated the impact of feedback and financial incentives on physician compliance with cancer screening guidelines for women 50 years of age and older in a Medicaid health maintenance organization (HMO).

Methods: Half of 52 primary care sites received the intervention, which included written feedback and a financial bonus. Mammography, breast exam, colorectal screening, and Pap testing compliance rates were evaluated.

Results: From 1993 to 1995, screening rates doubled overall (from 24% to 50%), with no significant differences between intervention and control group sites.

Conclusions: Financial incentives and feedback did not improve physician compliance with cancer screening guidelines in a Medicaid HMO.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Female
  • Guideline Adherence / standards*
  • Health Maintenance Organizations / economics
  • Health Maintenance Organizations / standards*
  • Humans
  • Mass Screening / statistics & numerical data*
  • Medicaid / standards*
  • Medical Audit
  • Middle Aged
  • Neoplasms / prevention & control*
  • Philadelphia
  • Physician Incentive Plans / economics*
  • Physician Incentive Plans / organization & administration
  • Practice Guidelines as Topic*
  • Program Evaluation
  • Reimbursement, Incentive*
  • United States
  • Women's Health