Wall Street Journal Examines Inclusion of Specialists in Pay-for-Performace Programs
The Wall Street Journal on Wednesday looked at the expansion of pay-for-performance programs to include 12 "high-volume" specialists, including gastroenterologists, orthopedic surgeons, gynecologists and cardiologists. The programs rate physicians on how well they follow proven measures of care for common conditions and award them bonuses equal to as much as 20% of their annual salaries.
The programs for specialists focus on areas where there are "widely accepted standards of practice" and enough data exists to "measure how well an individual doctor stacks up to his or her peers," according to the Journal.
Data from California-based MedVantage show that the number of pay-for-performance programs likely will double over the next two years, after growing by about one-third this year, the Journal reports. About 42% of pay-for-performance programs are directed at specialists.
A Blue Cross Blue Shield Association survey found that 78% of the public would value information about how well physicians apply best practice guidelines, even though such "scorecards" do not measure "how well patients fared," according to the Journal.
Some physicians "object" to pay-for-performance programs and view them as "interference," according to the Journal. Some specialists expressed concern that no consensus exists on certain procedures and treatments, so fair program criteria might be difficult to establish. "There are a lot of established markers for quality care in our specialty, but even in those there is disagreement," Ronald Vender, a partner at the Gastroenterology Center of Connecticut and clinical professor of medicine at Yale University, said, adding, "I think we'd all be receptive to an honest program whose goal was to improve the quality of care, but the trick is to come up with measures that are generally agreed on and don't require costly investments to collect all the data" (Landro, Wall Street Journal, 12/15).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.