Monday, January 28, 2013

Is P4P DOA?

Carrots For Doctors by Bill Keller.  Op-Ed Columnist.  The New York Times.  January 27, 2013.

Providing a critique and outline of the limitations of pay for performance (P4P) for doctors, Keller goes beyond criticism to delineate ideas that may work better.  Pay for performance, according to the piece, does not address the biggest cause of high cost of American health care as compared with other nations.    The reason other nations can devote less of their GDP to health care is that their system is single payer, providing bargaining power sufficient to require lower costs from suppliers.  However, single payer seems not to be politically feasible in the United States as Keller notes. Not rejecting financial incentives totally, he provides some  interesting ways to structure them so that they might work better than P4P.  One idea is to give hospitals performance bonuses at the beginning of the year with a refund required at year's end if performance goals are not met.  An interesting and insightful piece.

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