September 30, 2010 Paying Doctors for Patient Performance

[speppin]

Lots of echoes with teacher "reform" (paying more if students get good test scores). More of same stupid mentality!

http://www.nytimes.com/2010/10/01/health/01chen.html?src=me&ref=health


September 30, 2010
Paying Doctors for Patient Performance
By PAULINE W. CHEN, M.D.

Not long ago, a fellow doctor told me that his local health care insurers, in an effort to improve care and rein in costs, had been evaluating physicians and paying them according to their “quality ranking.” With “pay for performance” reimbursement, doctors who had, for example, managed more timely follow-up and achieved better test results with their diabetic or hypertensive patients would rank more highly and earn more in financial bonuses than physicians whose patients failed to meet the insurers’ guidelines.

Despite his own solid “ranking,” my colleague found himself growing more and more disenchanted with these types of reimbursement programs. “It sounds like a great idea,” he said, “but it assumes that what I do or say always has a direct effect on my patients’ health.” He described a long-term patient he had seen earlier in the week; she had poorly controlled diabetes yet failed to come into his office regularly in spite of his numerous requests.

“She just can’t afford to take that much time off from work,” he said, adding with a sigh, “Does that make me a worse doctor?”......................