Health Engineering Group

The Pay-For-Performance (P4P) Design Symposium

Components Proven to Improve Outcomes:  Making it work in New York.
Focusing on the Science of Medicine, not the Business of Medicine

Pay-for-Performance (P4P) is here to stay.  Physicians must take the initiative to protect their patients and their own interests.  P4P is arguably the most important shift in payments to physicians since HMOs.  Your participation in this one-night Symposium may be one of the most important elements of your responsibility and legacy to your constituents.  Fiscal intermediaries are imposing rules and P4P programs that are hurting patients, costing physicians more, misrepresenting physicians, and creating more bureaucracy.

Some of the top New York employers are joining together to address skyrocketing healthcare costs. Employers want to deploy a better system that works for both the doctor and the patient: Focus on quality of care: Instead of controlling costs by restricting employees' access to specialists or validated therapies, Merrill Lynch  and others say they saved money by focusing on the quality of care and early detection.  It is time for a P4P program devised by physicians.

??we need choice -- the leeway to pick the physicians, hospitals? that do the best job treating patients in our communities?But choice alone does little good if we can't distinguish excellent from mediocre, let alone atrocious. Most of us know more about the effectiveness of our deodorants than we do about the competence of our surgeons.?-NYTimes

?A physician who takes care of patients with diabetes, for example, virtually gets no reimbursement for sitting...and instructing the individual ...to prevent the side effects of diabetes.  However, if that person goes on to destroy their kidneys from diabetes, it is easy to get reimbursement for hemodialysis (for the rest of their life) ... this makes no sense whatsoever.  This is NOT how we ought to be practicing healthcare... It doesn't make any medical sense and it doesn't make any economic sense.?  Ralph Snyderman MD Chancellor Emeritus - Duke University 2006

?We are working like we are on an assembly line.  Literally, we are being told that 30 minute visits have become 20 minute visits, have become 12 minute visits... A doctor can't think with one eye on the clock...Another study showed that people come to the doctor often with five issues they want to discuss... the first issue gets a minute, and the other four get about 30 seconds to a minute because visits now so often are clocked in short intervals..? Jerome Groopman MD - Harvard Medical School

 ??the system encourages people to get sick and then people get paid to treat them," said Dr. Matthew E. Fink, a former president of Beth Israel. NY Times Jan 06

Goals and Discussion Points:

?   Allow Practitioners to Practice THEIR Way to achieve successful outcomes. 

?   Pay the Practitioners to practice their way.

?   Payments Sooner ? Reduced time, less paperwork.   

?  How can an effective P4P program be integrated with the fiscal intermediaries?

?  Allow Practitioners to reduce patient load, work more closely with existing patients ? without sacrificing income.

?  Track patient outcomes by practitioner, and by condition.  ?Linking reimbursements to outcomes will de-facto lower costs.? ? Jeff Immelt GE Chairman and CEO