Pay for Performance Programs and “Provider Disbelief”

Wednesday, September 12th, 2007
This post was written by Melanie Matthews

In last Tuesday’s New York Times, infectious disease physician Manoj Jain M.D. explains four reasons for physician reluctance to endorse or participate in a pay for performance program. The medical director for Medicare’s quality improvement organizations in Tennessee and Georgia says doctors are loyal to fee-for-service systems.

His comments echo what we’re hearing from the industry. During a June 2007 non-scientific e-survey on pay for performance (PFP) in healthcare, fewer than half of the 157 respondents said their organizations participate today. An oft-cited roadblock to implementation is provider/stakeholder buy-in. One respondent blamed the reticence on “provider disbelief.”

A creative approach from one respondent: Run the numbers and show providers how much money they’ve lost by not submitting timely data and not getting members and patients in for recommended screenings.

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