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Lack of centralized care impedes pay for performance

Physician Practice Advisor, March 21, 2007

The lack of centralized or coordinated care for Medicare beneficiaries may be a significant obstacle to implementing a pay-for-performance reimbursement system, according to a study published in the March 15 issue of the New England Journal of Medicine.

Researchers analyzed claims from 2000-2002 for 1.79 million fee-for-service beneficiaries, and determined that beneficiaries saw a median of two primary care physicians and five specialists, working in four different practices during that time period. Only 35% of beneficiaries' visits each year were with their assigned physician, and one-third changed physicians from one year to another.

Researchers observed that patients saw too many providers to assign responsibility to a single physician. This dispersion of care will limit the effectiveness of pay-for-performance intiatives that rely on quality measures assigned to a single physician, they concluded.

Click here to access the New England Journal of Medicine study.