P4P Results not as good
HealthDay News recently reported that the 2004 pay-for-performance scheme for family practices in England resulted in short-term quality of care improvements for asthma and diabetes, but not for heart disease, and ultimately was associated with a long-term slowing in the rate of improvement for all three conditions. The results are published in the July 23 issue of the New England Journal of Medicine.
The researchers analyzed quality of care measures at 42 family practices at two time periods (1998 and 2003) before the scheme implementation and during two time periods (2005 and 2007) after implementation. They found that rates of quality improvement for asthma, diabetes, and heart disease -- regardless of whether or not the aspects of care were associated with incentives -- significantly slowed after 2005.
They summarized it this way; "If the aim of pay for performance is to give providers incentives to attain targets, the scheme achieved that aim," "There may have been unintended consequences, including reductions in the quality of some aspects of care not linked to incentives and in the continuity of care."
This study validates what most physicians already know. The practice of Medicine is an art based on science. Arbitrarily setting goals will not necessarily improve patient care; but it may make the number-crunchers and attorneys in Washington happy.
If Obama and the Dems pass this radical agenda on healthcare, quality will worsen just as it is in other countries
The researchers analyzed quality of care measures at 42 family practices at two time periods (1998 and 2003) before the scheme implementation and during two time periods (2005 and 2007) after implementation. They found that rates of quality improvement for asthma, diabetes, and heart disease -- regardless of whether or not the aspects of care were associated with incentives -- significantly slowed after 2005.
They summarized it this way; "If the aim of pay for performance is to give providers incentives to attain targets, the scheme achieved that aim," "There may have been unintended consequences, including reductions in the quality of some aspects of care not linked to incentives and in the continuity of care."
This study validates what most physicians already know. The practice of Medicine is an art based on science. Arbitrarily setting goals will not necessarily improve patient care; but it may make the number-crunchers and attorneys in Washington happy.
If Obama and the Dems pass this radical agenda on healthcare, quality will worsen just as it is in other countries
Labels: healthcare, Obama, P4P
posted by Anonymous at 5:36 AM
9 Comments:
So teachers should be held accountable for outcomes but not docs?
P4P is just another Democrat scheme to try to solve problems(that they created) by issuing more directives. Democrats never look to the free market and capitalism for solutions. That is because they believe in a strong central government that totally controls every citizens' lives - they are "Power Mongers." This whole health care reform debate gives more credence to the biggest lie in the world - "I am from the Government, and I am here to help you."
What could be more "free market" oriented than pay for performance? Anything else is just subsidized mediocrity.
If I charged $120 and up for five to 10 minute office consultations during which no tests are run and no diagnoses are made, I'd probably be against the notion of outcome measurement as part of pricing schedules, too.
That's the reality patients often face, only to be told that they don't do a good enough job of "shopping around" for a doctor in support of the free market.
Bluegill,
I have no clue what you are saying.
Are you high on something or just shooting off your mouth as usual.
Primary care doctors do not charge anywhere near 120 dollars for a routine office visit.
Get a clue
Why should doctors care more or less based on pay from the governemnt?
Is a physicians ability to comprehensively diagnose, treat and maintain a patient directly related to the girth of their wallet?
anybody know what bluegill does for a living or if he works? His profile is very limited.
most doctors offices, for just a general family practitioner charge $60 to $80 per visit, double and triple that for "specialists". Bluegill is obviously cutting it down the middle and presenting the information as it relates to a actual cost of the visit, not the copays a patient pays at the window. Makes sense to me.
I have to agree with the anonymous poster who asked the question regarding patient care directly related to pay for the doctors.
To me, (and I am not a doctor and dont pretend to be one), when a practice is switch from patient care driven to financial gain driven, the quality of care is put in second place.
If by some reason that by being offered incentives to increase more positive outcomes, then that shows me that the doctors in the study were not providing full care and respect to the patients before the incintives were offered.
Even the slightest hint of evidence that indicates this is sickening at best.
Every single patient should be treated with the utmost attention and care as indicated by their needs, whether the provider stands to get more pay for it or not.
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