Wednesday, April 13, 2005

With the AMA's Pay for Performance principles and $ 4 you can get a grande Frappuccino at Starbucks

In my most recent post I mentioned the AMA's pay for performance (PFP) principles. They are reasonable, well thought out and have no relationship to what managed care companies will do.
If you are looking for principles to construct a program that would reward physicians for quality care (I know that begs the question of can you even measure quality), the AMA list would be a good place to begin. Such a program would actually cost more money. If you look at the incentives and constraints under which managed care operates, spending more money is not in their interest.
Can anyone recall a program initiated and supported by managed care that was designed to increase quality care by spending more money? Is there really anyone who is fooled by managed care's talk about pay for performance? Both the AMA and ACP talk about PFP but seem to mean something entirely different from what recently was imposed by United Healthcare. Do the folks at either doctor's organization really believe that their talking about PFP will have any impact on what the insurers do ?
I am reminded of Charlie Brown running still again to place kick the football with Lucy holding,this time-he thinks-she won't let go.

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