|What's Missing In Physician Performance Measurement
Physician performance measurement programs that have
been developed by health plans are not enough to prompt doctors to
really improve performance, according to the Center for Health System
In essence the existing measurement programs only measure, and that's not enough.
"Support to improve performance and rewards to encourage
and reinforce desired behaviors" are the missing ingredients for
meaningful performance improvement, said Debra A. Draper, Ph.D, an HSC
The HSC is a non-partisan policy research organization
funded in part by the Robert Wood Johnson Foundation. Early efforts to
measure physician performance may prove a lost opportunity to improve
upon the nation's healthcare system if shortcomings are not promptly
Most performance measurement programs have been
developed by health plans, and are broadly similar. However, their
methodologies often differ on important dimensions, which makes it
difficult to compare individual plan results with physicians being
deemed high performing by one plan, and not another.
There are a number of key challenges to effective
physician performance measurement that require both change and growth,
as outlined by Draper on behalf of HSC. These are:
- Development of a consensus on physician performance measurement program standards.
- A convening entity is needed with the necessary
capacity to neutralize existing competing dynamics and to champion the
area of physician performance measurement.
- Supporting physicians willing to improve and handsome rewards for those demonstrating good results.
- Combining data from all payers, including Medicare
and Medicaid, to conduct an accurate assessment of physicians across
their entire patient panel, and not piecemeal (individual plans). This
will likely require federal government intervention and mandate.
- Despite the United States spending more than $2
trillion annually on healthcare, patient outcomes lag behind other
developed countries that spend far less per capita, according to Dr.
"The disconnect between money spent on healthcare and
the often less-than-stellar results has sparked national awareness of
the critical importance of measuring and improving healthcare quality
and slowing spending growth through increased efficiency," Draper
"Although the challenges outlined here are formidable,
failure to take appropriate steps to improve the current state of
physician performance measurement may result in a lost opportunity to
improve quality and efficiency of the underperforming U.S. healthcare
system," Draper said in an HSC commentary.
Address: Center for Studying Health System Change, 600 Maryland Ave, SW #550, Washington, DC 20024; (202) 484-5261, www.hschange.com.