Pay for performance becoming business as usual

Over the past year, pay for performance programs have gone from novel to an expected way of doing business. Not only have private health plans thrown their weight behind P4P programs, CMS has as well, with 155 P4P programs emerging this year alone, according to Leapfrog Group estimates. And while many of these programs are voluntary--adding a new pot of money that they can fight for above and beyond their compensation--many providers are bowing to the inevitable. For one thing, hospitals and medical groups have invested multiple millions in health IT upgrades this year, which they're using to track how well they're complying with P4P program standards.

This is not to say that P4P programs have matured completely. In fact, despite the upsurge of commercial health plans inserting P4P provisions in their contracts, there's still little been agreement on how to measure quality over the past year. Given how complicated it can be to adhere to a variety of quality programs with varied standards, physicians and hospitals have become a bit exasperated with the situation. Meanwhile, over the past year, a battle has begun shaping up over whether providers will have to "win back" some of their existing pay through conforming with P4P standards (something CMS is already demanding). Folks, this debate is going to get ugly.

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