P4P Pitfalls
Many have heard about Medicare’s plan they will implement very soon. It is called “Pay for Performance” or P4P. They reportedly will be paying more to physicians whose patients meet certain clinical benchmarks. But the whole process is entangled with government bureaucracy and will have many complications.
The typical Medicare patient has several physicians and it is going to be a nightmare trying to determine which physicians are responsible for what.
This is the conclusion from researchers at the Center for Studying Health System Change (HSC) and the Memorial Sloan-Kettering Cancer Center.
They showed that the typical Medicare patient is seen by seven different doctors in at least 4 different practices in any given year. They went on to show that only about 35% of the beneficiaries visits were with the doctor held responsible for the care under the P4P methodology.
Medicare plans to use claims data retroactively to assign responsibility to the providers, but this doesn’t give the provider an opportunity to know in advance which patients he/she should be advising on certain tests and procedures.
How this system will help is up in the air. It will add more hassles and oversight and will create even more cost to an already burdened system. The benefits are questionable. Patients are the ones who should be held responsible for their healthcare.
Labels: healthcare, P4P
posted by Anonymous at 6:05 AM
2 Comments:
Hold everyone else accountable, but for goodness sakes, don't try to evaluate doctors.
This seems like it will be, at best, marginally beneficial--assuming it could/would ever operate fairly and smoothly. The MD could only bear so much responsibility for patients meeting or not meeting benchmarks, even if the MD did do everything right. It doesn't sound nearly as "performance" based as it does "this-is-90%-out-of-your-control-but-we-need-to-keep-ourselves-busy-and-Medicare-D-wasn't-torturous-enough" based.
Seems like this would fit well with the electronic record-keeping we recently discussed, but of course I'm sure that would make things to easy. I don't mean to be cynical about it, but geez, if anyone knows how to cut their noses off to spite their faces, the Feds do. It's almost as if they sit around brainstorming with the agenda of, "There must be a harder way..."
CMS is also considering this P4P approach with in-patient health care facilities, but it seems more reasonable when there is more of a clear-cut, cause/affect relationship between organizational operations and quality of care.
Post a Comment
<< Home