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Home / News & IndustryManaged Care Insight and Analysis
Updated: September 22, 2009
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 Change (HSC).

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 senior fellow.

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 addressed.

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. Draper.

"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 points out.

"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,

  This article was taken from:
Pay-For-Performance Reporter

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