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Issue Date: August 2007
Federal P4P Results Raise Questions
When evaluating pay for performance (P4P) programs, it’s important to consider the source. It’s not unusual for proponents of P4P to promote these programs by saying they produce remarkable results. Opponents of P4P, meanwhile, readily point out the flaws.
Last month, the federal Centers for Medicare & Medicaid Services (CMS) reported that its demonstration project involving P4P for 10 large physician groups was a success. And, by many measures, this statement is true. But, only two of the 10 groups received any financial performance incentive. All participating physician groups improved the clinical management of diabetes patients in the first year of the three-year Medicare Physician Group Practice Demonstration, CMS said.
How to Recruit and Retain Specialists
Recruiting physicians is a major undertaking for any medical practice, whether the practice is looking to grow through the addition of an associate, or seeking to fill an open position. With the nation’s diminishing pool of physicians, recruiting takes longer than it did in years past and often requires intensive search activities. Even with professional assistance, the process can take a significant amount of time away from clinical and other administrative responsibilities.
Since there’s a heavy investment of time and resources, it’s little wonder that practices also hope to retain the individuals currently on staff. And because turnover is costly, it’s important that practices retain qualified and productive physicians.
High Revascularization Rates Found in Markets with Cardiac Hospitals
Some cardiologists have developed specialty cardiac hospitals to gain greater control over patient care and to help them improve practice efficiency in an era of rising costs and declining reimbursements. Opponents of such specialty hospitals, however, assert that hospital ownership creates incentives for physicians that do not always ensure optimal care or the best resource use.
Researchers examined the concern that specialty hospitals promote overutilization of health care procedures in a study published in the Journal of the American Medical Association on March 7 (JAMA. 2007;297:962-8). In this study, the researchers found that rates of cardiac revascularization procedures, such as coronary artery bypass graft (CABG) and angioplasty, or percutaneous coronary intervention (PCI), were higher in health care markets with new cardiac hospitals than rates found in other markets.
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