Reforming the physician payment system to focus on health outcomes is an idea common to most plans.

The more fundamental question is whether paying doctors more to meet quality measures actually benefits patients.

So far, no definitive data suggests that’s the case. Jason Shafrin points out that the rewards in current pay for performance proposals pale in comparison to the UK, where the average physician practice earned $133,200 in reward-based payments. This results in “little behavioral impact” for American doctors.

Furthermore, he cites a study which suggests that paying doctors for outcomes simply leads to better documentation without consistently improving patient care:

Is P4P rewarding doctors who have rich patients that see the doctor often? Is P4P rewarding doctors who document care more accurately? Or is P4P really improving the quality of medical care?

Because P4P is such a blunt instrument, policymakers and insurance companies cannot answer these questions.

Policymakers don’t appreciate the nuance and unintended consequences surrounding pay for performance initiatives, and fail to acknowledge that there is little data concluding that paying for quality improves patient care.

topics: pay for performance, patients