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Rewarding provider cooperation: P4P report suggests payment reform

Hospitalist Leadership Connection, December 23, 2008

Pay-for-performance programs should not simply reward physicians individually but reward them for working with all provider settings to improve patient care, according to a new report by Mathematica Policy Research. Under the philosophy that payment reform could improve the overall healthcare system, according to a Dec. 15 Mathematica press release, the policy research firm stated that, too often, the current pay-for-performance system uses incentives of patient volume and procedures, instead of other important issues, such as caring for vulnerable populations or coordinating with primary care physicians.

Mathematica identified key components to pay-for-performance implementation, including the following:

  • Use broad set of measures
  • Incentive size is important
  • Feasibility of pay for performance varies with practice settings
  • Physicians should engage in pay for performance

“We need to better match the incentives in our system to the goals and performance we seek from the health care system. Payment incentives should encourage physicians to be concerned about the total patient experience, including care they do not provide directly,” said Mathematica senior fellow and lead author of the report Marsha Gold in the press release.

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