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Big demand for pay-for-performance knowledge
A few years ago, pay-for-performance was mostly a subject of academic papers--and a few pioneering experiments on the West Coast. But things have changed a lot since then. At this year's MGMA, not only are there cutting-edge sessions and doubtless, tons of hallway chatter and knowledge-swapping, there's even a two-day pre-show seminar focused specifically on P4P. This isn't much of a surprise given that Medicare is throwing its weight behind performance incentives, too. Still, things have changed pretty quickly.
Despite all of the noise around P4P, though, don't expect to find that your colleagues at the show are experts on the subject. It's become clear over the last year or two that meeting performance standards isn't just time-consuming, it's also expensive, as it usually takes IT upgrades and added staff. In most cases, in fact, small practices just haven't had the means to take part.
Maybe this year, the smart folks who network at the show will find some new ways to make P4P accessible to more practices. In the meantime, take any chance you get to find out what the big boys are doing. There's lots of knowledge out there that hasn't been codified into standard P4P techniques, so soak it up while you can.
Comments
By Marshall Maglothin | Posted 10:05am | October 26, 2008
Given the numerous data obstacles and costs to payor P4P programs, I am astounded that physicians have been so slow to engage hospitals in Pay-for-Quality and Gainsharing programs.
Expenses for hospitals exponentially dwarf those of their physician practices, and physicians drive over 60-80% of hospital costs through Length-of-Stay, diagnostic tests, procedures, and procedure-related complications.
A number of different models have been successfully (and legally implemented), and have improved quality while significantly compensating the involved physicians for their improved outcomes, product cost savings, and non-clinical consultation time: workflow consulting, new product evaluation and process implementation, team guidance, and benchmarking and tracking quality indicators. The OIG has formally approved a string of “traditional” Gainsharing programs, the latest one in August with an orthopedics program.
Very few hospitals will seek out physicians to offer to share savings with them. As we see today, the trend is that hospitals will increasingly require physician non-patient care time for data measurement, capture and reporting, and then keep P4P hospital compensation totally for themselves.
It is up to hospitals’ medical staffs to begin to demand that they are compensated for the significant quality improvements they make.
Gainsharing is a means of achieving this, while ensuring demonstrated compliance with Federal laws and rules.
mmaglothin@cox.net
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