May physician targeted performance payment finally receive its death toll

Long time readers of this blog know my disgust with pay for performance.  P4P has many incarnations, all of which are harmful to patients and physicians.  The blogosphere has ranted about this for at least 11 years.  Search P4P on this blog and you will see the vast number of posts regarding this topic. This week’s Annals of Internal Medicine has a wonderful article and editorial that strongly indicts “value based payment”: Value-Based Payment Modifier: Outcomes and Implications | Ann Intern Med | ACP | http://bit.ly/2irAneF Changing How We Do Pay for Performance | Ann Intern Med | ACP | http://bit.ly/2ipBZ94 The editorial (VM refers to Medicare Value-Based Payment Modifier) includes: Using a sound analytic approach (exploiting discontinuities in VM design by practice size and time), McWilliams and colleagues found that VM bonuses and penalties had no effect on the quality or efficiency of care delivered. These results are consistent with those of previous studies of physician P4P programs (2) as well as a larger body of evidence around hospital-focused P4P programs (3–5). All told, evidence that P4P improves care is scant. Worse, the authors found that the VM likely has exacerbated existing disparities in care. Because the Medicare VM does not adjust for socioeconomic status (SES) or illness severity, practices that care for lower-income or sicker patients received greater penalties, essentially creating a reverse Robin Hood effect (6). Likewise, the M...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs