Physicians should seriously weigh the benefits and risks involved prior to discussing the possibility of genetic testing with a patient or referring them to a genetic counselor.
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.
Two physicians offer commentaries about the use of prenatal predictive testing for a late-onset disease like Huntington's and question whether the pregnant woman should ultimately have the decisional autonomy to determine the quality of life of the unborn child.
Two physicians offer commentaries about the use of prenatal predictive testing for a late-onset disease like Huntington's and question whether the pregnant woman should ultimately have the decisional autonomy to determine the quality of life of the unborn child.
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.
Chromosomal microarray analysis reveals many gene variants of unknown significance. The uncertainty about these variants—might they be deleterious or are they benign?—complicates genetic counseling.
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.