Paying Doctors on the Basis of Patient Outcomes
A doctor described to a colleague a long-term patient who he had seen earlier in the week. She has diabetes that can be controlled but has failed to come into his office regularly even though he has contacted her many times. The doctor is highly ranked on quality measures that the local health insurer has laid out for evaluating and paying physicians to improve medical care and cut costs. Yet the doctor asked this colleague about his infrequently seen diabetic patient: “She just can’t afford to take that much time off from work. Does that make me a worse doctor?”
In pay-4-performance plans established by Medicare and private health insurers, the basic assumption is that,
