Appropriate use of the pay-for-performance system may improve quality of care by counteracting physician incentives to overtreat in fee-for-service situations or undertreat in capitation plans.
The objective is to compare the costs of providing the same level of quality. When resource-use and quality measures are juxtaposed, the resources used to provide the same level of quality can be compared.
The FDA’s approval for over-the-counter sales of emergency contraception marked a departure from its standard approval process and obstructed access to a safe and effective drug. That departure could set a dangerous precedent for future decisions.
Shivan J. Mehta, MD, MBA and David A. Asch, MD, MBA
Outcome-based payment more closely aligns payments with what patients want, which is better health rather than more health care. But these approaches remain challenging to implement.
Measuring outcomes alone is not the answer. There should be a way to reward the doctor for educating a patient about lifestyle modifications and then documenting that the care provided followed patient preferences.
The picture that emerges from study of physician economic behavior is mixed, but from the intensity of responses by some professional societies to Medicare's coding modifier proposal, it appears that economic incentives matter a lot to many of their members.