Assessment of Medicare Pay-for-Performance Incentive
A recent study published in the New England Journal of Medicine (pdf) examined the practical implementation of Medicare’s plans to reward physicians for performance. One of the biggest hurdles noted by study authors was identification of the appropriate physician to remunerate.
The challenge is particularly complex considering that older adults often see multiple doctors to address a variety of chronic conditions. This is further compounded by means to map treatment back to best practice models for quality which would guide the pay-for-performance model.
On average, authors noted that Medicare patients actually saw two primary care practitioners annually, in addition to five specialists in four distinct practices. And that was an average, analyzing subsets of patients with chronic conditions revelaed that some Medicare recipients see ten or more physicians annually. Determining the physician with primary oversight for one patient’s care becomes difficult.
Authors suggest that one intermediate step would be a focus on overall management of care and then investigate institution of performance-based incentives.
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March 27, 2007 Related topics: Legal & legislative, Finance