The Health Value of Carrots

A new study published in Health Affairs provides compelling evidence that “carrots” — in this case, not the vegetable, but rather financial incentives — can make a significant difference in modernizing medical practices and improving patient health.

In this case, the practice being focused upon is e-prescribing.  Prior to 2008, it wasn’t happening to any great degree.  According to an article on the Health Affairs blog by Max Sow, head of business intelligence for Surescripts (a Healthcare Leadership Council member), only six percent of office-based physicians, about 40,000 healthcare providers in all, had moved from pen-and-paper prescribing to digital before Congress passed the Medicare Improvements for Patients and Providers Act (MIPPA).

We know now that the financial incentives contained in MIPPA made a difference in physicians modernizing their prescribing practices.  The certainty is provided by Surescripts’ prescription data which, unlike a survey of doctors, leaves no room for false answers or misinterpretation.  Clear patterns can be seen in the data on when and where e-prescriptions are being issued.

The study published in Health Affairs shows that, for a 26-month period prior to the creation of financial incentives through MIPPA, there were an average of 1,437 new e-prescribers per month in the physician community.  After those incentives were implemented, the number of new e-prescribers per month jumped to an average of 6,346 from 2008 to 2010.  This growth wasn’t isolated to any particular geographic area, but took place nationwide.

The benefits to patients from this paper-to-digital shift were considerable.  With e-prescriptions, the prospects for medication error are reduced because pharmacists aren’t trying to interpret doctors’ handwriting and digital networks strengthen the ability to identify possible conflict between drugs a patient is taking.  Also, studies have shown that medication adherence rates improve when prescriptions are transmitted directly to the pharmacy.

The Surescripts data takes on great importance at a time in which policymakers are striving to make health information technology adoption universal throughout the healthcare system.  The numbers on e-prescribing show us the value of carrots in achieving meaningful transformation.