tag:blogger.com,1999:blog-5121723593802011786.post6351361474595331194..comments2024-03-20T18:21:06.690-04:00Comments on Annals of Internal Medicine: Fresh Look Blog: Getting What We Pay for in Pay-for-Performance ProgramsAmerican College of Physicianshttp://www.blogger.com/profile/15978682034152790218noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-5121723593802011786.post-44664132698955881832018-02-05T01:41:24.122-05:002018-02-05T01:41:24.122-05:00Thank you for these comments. I agree that it is i...Thank you for these comments. I agree that it is important to ensure we are testing appropriate hypotheses with policy interventions and appropriately evaluating the results, and also that prior P4P demonstrations have not necessarily been ideal in terms of incentive desire and behavioral principles. I also think testing multiple approaches is important to identifying which payment models are most effective in different circumstances. Nonetheless, because the data we do have appears pretty consistent, what would be potential options for exploring P4P further?Joshuahttps://www.blogger.com/profile/16371947510432751178noreply@blogger.comtag:blogger.com,1999:blog-5121723593802011786.post-88522660680465938252018-01-29T16:42:56.692-05:002018-01-29T16:42:56.692-05:00Great points in the fight between P4P and other va...Great points in the fight between P4P and other value-based care initiatives. As a general principle in quality work, changing the "targets" will not result in changes in the underlying process, rather it might lead people managing the process to distort the reporting of results to meet the desired metrics. <br /><br />I hesitate to agree with the authors that the final nail in the coffin has been shut for P4P b/c while it hasn't worked out quite as we'd hoped, we all should acknowledge that from the outset we knew this would be a painful experience with many failures before we got closer to getting it right. The question is are we at that point? I don't think so, particularly because we haven't leveraged the full capabilities of our healthcare system to try to successfully deploy P4P. Many places aren't fully utilizing our EHRs to provide interpretable and actionable real-time electronic clinical quality measures to help providers improve. I think we should keep pushing for P4P, while deploying other value-based initiatives (ACOs) elsewhere so as to not mix results from each and allow for appropriate study of each initiative individually. NaveedQhttps://www.blogger.com/profile/11687449069216443541noreply@blogger.com