Physicians Urged to Engage Pay for Performance

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WASHINGTON -- Physicans may never embrace pay for performance with open arms, but they do need to get in the game.

That was the message delivered by policy experts speaking at meeting of annual research meeting of Academy Health.

Hospitals have viewed pay for performance "as something that is coming down the pike, and they're getting ready for that," said Melony Sorbero, Ph.D., a researcher with the Rand Corporation.

In recent interviews conducted by Rand for studies on existing pay-for-performance programs, hospital staff expressed much less resistance than did physicians.

"Hospitals have an organizational framework, staff, and systems to be able to respond to these programs," said Cheryl Damberg, Ph.D., a senior Rand researcher.

For hospitals, the question is how many measures are being requested and what the technical requirements are for reporting the data. For physicians, the problem is a fundamental: How will they collect the data in the first place?

"Physicians for the most part lack the infrastructure. Their data systems aren't anywhere near what hospital data systems are," said Dr. Damberg.

However, physicians do have opportunities to get involved with the development of pay-for-performance measures. There are hundreds of pay-for-performance experiments currently engaging physicians, while only about 40 programs are aimed at hospitals, said Dr. Sorbero.

The American Board of Internal Medicine is behind one such effort targeting physicians. The organization recently completed a study to see whether physicians can be ranked based on a combination of chart reviews, patient surveys, and practice system surveys. They assessed the consistency of those data individually and together. …