Timing is important when it comes to provider pay-for-performance programs, says Kenneth Kizer, M.D., who is leading the not-for-profit National Quality Forum in an effort to establish a set of baseline best practices for these quality-improvement efforts.
A maxim of quality experts is you can't improve what you can't measure and, at the moment, pay-for-performance programs are "all over the board" in their design and operation, said Kizer, president and chief executive officer of the NQF. Absent a set of guiding principles, "it will be difficult to compare them and see what's working and what's not."
So at the request of the CMS, the NQF will call a workshop early next year in Washington to begin working on benchmarking baselines for the variety of pay-for-performance programs initiated by governments, employer groups, payers, consumer organizations and physician organizations.
The Leapfrog Group recently announced there are 86 pay-for-performance programs listed on its Web site, according to Kizer. The business healthcare coalition, with help from the Commonwealth Fund and the Robert Wood Johnson Foundation, began tracking in late June and started with a list of 77 programs.
"What we don't want to do is stifle good ideas or cut off innovative approaches," Kizer said. "This was simply to bring the people together and start the dialogue on what's working and what are the essential building blocks. What we can do is play a role to help find a middle ground. No one knows what's best at this point. We have to try different approaches. The devil is in the details."