Pay for Performance
Resident Grand
Rounds
·
Pay
for Performance is a new health policy initiative that seeks to link incentive
payments with measurable quality goals for physicians
·
Pay
for Performance has evolved from recent research that shows Americans are not
receiving consistent, high quality medical care as well as the hope that health
care cost containment can occur
·
Multiple
Pay-for-Performance programs are currently underway, sponsored by both public
and private efforts and can be found in hospital and ambulatory settings
·
Evaluation
of HMO-based Pay for Performance program
on three indicators of quality – cervical cancer screening, mammography, and
hemoglobin A1c testing
o
Pay-for-Performance
groups only did significantly better in one area, cervical cancer screening
·
The
Centers of Medicare and Medicaid Services (
o
Evaluation
of this project reveals that Pay-for-Performance hospitals consistently
performed better than control hospitals although results were modest
·
Challenges
for Pay-for-Performance Programs:
o
How
should bonuses be paid?
o
Should
the current size and scope of Pay-for-Performance programs be changed?
o
How
can programs ensure that there will be no selection bias against sicker or less
adherent patients?
o
Should
there be standard clinical areas and clinical measures?
o
Should
there be negative consequences to ‘overuse’ of the health care system?
·
Despite
the many challenges and modest results of Pay for Performance programs, they
are becoming increasingly popular and will likely continue to proliferate in
the near future