As the nation’s largest payer for health care services, the Medicare program has a major effect on payments to providers. Its ability to align incentives through pay-for-performance will have implications for the health delivery system at large. A recent Institute of Medicine report made recommendations for implementation of “P4P” under Medicare.
Proper implementation will require among many other things, assessment of the adequacy of clinical measures, implementation and improvement of health information technology, and increased provider compliance with public reporting requirements.
What have been the results of recent Medicare P4P provider demonstration projects? How was the effectiveness of pay-for-performance measured in those demonstrations? Is pay-for-performance a workable model for all Medicare providers? If so, how much funding would be required to implement P4P more broadly and where would such funding come from? What types of P4P efficacy measures would be necessary going forward? Will Congress need to more permanently address the Medicare physician payment formula in order for doctors to buy into pay-for-performance?
To discuss these and related questions, The Commonwealth Fund and the Alliance for Health Reform sponsored a December 15 briefing. Panelists were: Robert Berenson, the Urban Institute; Robert Galvin, General Electric; Alan Nelson, The American College of Physicians; and Gail Wilensky, Project HOPE. Ed Howard of the Alliance moderated the discussion.
Full Transcript (Adobe Acrobat PDF)
Speaker Biographies (Adobe Acrobat PDF)