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Tuesday August 8, 2006
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Paul J. Wallace, MD
Medical Director for Health and Productivity Management Programs;
Senior Advisor, The Care Management Institute and KP-Healthy Solutions
The Permanente Federation, Kaiser Permanente
 View Biography
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| Medical Pay for performance implies that a higher level of reward shall accrue to the provider whose care is timely, correct and is accompanied by uncomplicated medical and typically successful medical results. This reward basis is dependent upon a fundamental feature that identifies an inverse relationship between utilization of services and quality of care. In the ideal case, preventive care results in the greatest potential degree of both decrease in morbidity and thus, decreased utilization of care. In the case of amelioration of disease, timely care, precisely accurate diagnosis, medical treatment, follow-up care, and medical record keeping all serve to decrease and/or optimize medical expenses and suffering. |
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| Provider-focused P4P incentives can improve quality of care for some patients, but run the risk of reducing quality or access for others. Medicare faces additional challenges beyond those confronting private third-party purchasers. Given Medicare’s patient population, size, and sensitivity to interest group lobbying, any harm that could result from a P4P scheme would be more likely to occur within traditional Medicare than elsewhere in the health care system. This discussion will focus on ways that Congress can realize the potential of P4P within Medicare, while minimizing or avoiding such harms. |
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