tci Medicare Compliance & Reimbursement - 2006 Issue 3

PAY-FOR-PERFORMANCE: P4P Programs Not Reaching Small Physician Practices

Many physicians don't trust health plan-generated performance data.Despite the enthusiasm surrounding pay-for-performance pilot programs in both the public and private sectors, an influential think-tank has revealed a P4P backlash involving quality measurement disparities and certain physician groups. Although many industry leaders believe P4P will play an integral role in the future of health care, others are pointing to the flaws that could make implementation impossible.When the Center for Studying Health System Change performed its 2005 site visits to 12 nationally representative communities, HSC discovered that only two communities had "significant P4P programs." The other 10 communities...

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