 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Teresa J. Koenig, MEd, Bradford W. Hesse, PhD, Hilary R Kruger, MA, and James R Covell. Health Studies Group, Westat, 1650 Research Blvd., Rockville, MD 20850, 301-738-3633, teresakoenig@westat.com
OBJECTIVES. The effects of modulating monetary incentive rates on health care providers’ compliance with requests for medical records were determined during two pre-testing phases of the National Study of Health and Activity (NSHA).
METHODS. In Study 1, conducted in 2000 as part of a pilot study of operational procedures, medical record release forms and record request letters were submitted to 693 providers in four states. Providers were randomly assigned to one of three conditions for remuneration: $100, $36, and $0. In the $100 and $36 conditions, request letters specified the dollar amount that providers would receive for each set of patient records, and that payment would be rendered after the records had been received. There was no mention of payment in the request letters sent to providers in the $0 condition. Providers who requested a fee after receiving the request letter were reimbursed up to $100 per set of records, regardless of their assigned incentive condition. Study 2 was conducted as part of a field test of finalized procedures in 2002. Six hundred eighteen medical record-release forms and request letters were submitted to 504 providers in a localized geographic area. Conditions for provider remuneration were modified so that there was no mention of payment in the record request letter, however standard fee schedules were honored if requested by individual providers.
RESULTS. Providers complied with 84% of the record requests made during Study 1. A Fisher’s Exact Test of compliance by incentive condition revealed no statistical association between providers’ compliance and the manipulation of payment amount in the request letter. The mean payment made across all providers was $34.44; however, variance in the amount paid increased as a function of higher incentives. In Study 2, providers complied with 88.3% of medical record requests made. Of the 504 providers that were contacted, only 198 requested payments. The mean payment taken across all providers in Study 2 was $17.41.
CONCLUSIONS. The amount of a payment offered to records providers ahead of time did not affect compliance with requests for medical records during pilot testing for a national study. Through debriefings and focus groups, it was learned that the medical records staff who process the requests do not typically reap any benefits from financial incentives offered to providers. Outcomes from the two studies suggest that researchers could save money by adhering to providers’ standard fee schedules for requesting medical records, rather than offering money for incentives ahead of time.
Learning Objectives:
Keywords: Data Collection, Public Health Research
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.