To see what P4P is really all about, look at the Seattle Blue Shield experience

The May 26, 2006 posting on Health Care Renewal references a news report on the "quality" and P4P acitvities in Seattle.

As critical as I have been on the P4P issue, the reality seems even worse. In this case, according to the news report,the carrier dropped about 500 physicians from their plans by a secret quality assesment process (using biling records apparently), and sent letters to 8,000 patients telling them their docs were delisted because of quality and efficiency issues.

As an aside I would like to know why this is not libel per se or at least ordinary libel.

But that is not my main point. The following is:

If the physicians who advocate accepting P4P such, as the leadership at ACP, believe that P4P is or will be about thoughtful, well intentioned physicians agreeing on scientifically established quality indicators and compliant physicians being rewarded for showing they comply with them, I cannot help but believe they are either naive or disingenuous.It will be and-as in the Seattle case- already is about saving money and controlling physicians.

It was about a year ago that I blogged about the egregious "performance" program initiated by United Health Group in St. Louis. That program also had no resemblance to the features of a "good " P4P program that the AMA envisioned and was harmful to physicans and patients alike.

Physician groups who advocate P4P argue that if we do not work with the third parties to make the rules, all the rules will be made by them. The Seattle and St. Louis experience-as well as the entire managed care saga-tell us clearly the third party payers will make all the rules anyway.