Doc warns incentive pay could hinder quality efforts

Pay-for-performance for physicians as recommended by the Medicare Payment Advisory Commission could work against quality improvement efforts, an official for the Society of Thoracic Surgeons told the House Ways and Means Committee's health subcommittee. MedPAC suggested reducing Medicare payments to all physicians to create a bonus fund for high-quality performers, said Jeffery Rich, a cardiothoracic surgeon in Norfolk, Va., and chairman of the society's task force on pay-for-performance. But Rich said the budget-neutral approach could stop top performers from sharing best practices with lower-achieving providers. The goal of any pay-for-performance program should be improving the quality of lower performers to achieve savings in the long run, Rich said. He spoke at a hearing on ways to improve the quality and efficiency of physician care under Medicare. -- by Tony Fong