tci Medicare Compliance & Reimbursement - 2005 Issue 12
Coverage: Providers Still Wary of P4P System
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Article Overview
This article examines the debate over pay-for-performance (P4P) in health care policy. It summarizes viewpoints from payers, physicians, MedPAC, CMS, private insurers, the American Medical Association, and members of Congress, and it focuses on broader questions about whether participation should be mandatory and how physician resource use might be tracked and reported.
Why This Topic Matters
The topic affects how health care quality, efficiency, and payment policy are evaluated and reported. It is relevant to providers, payers, policymakers, and analysts interested in performance measurement and reimbursement strategy.
What You Will Learn
- How major health care stakeholders view pay-for-performance programs
- Why mandatory participation is part of the policy debate
- How physician efficiency and resource use are discussed in relation to claims data
- Which organizations are involved in shaping or evaluating the policy discussion
Who Should Read This
- Physicians
- Health care administrators
- Medical coders
- Health policy analysts
- Payers and insurers
- Compliance and reimbursement professionals
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