There is more buzz than bucks in physician pay-for-performance programs so far, according to an issue brief by the Center for Studying Health System Change, based on visits to 12 communities. Of the 12 communities, only Orange County, Calif., and Boston have significant physician pay-for-performance programs, according to the issue brief. In the remaining communities, "almost no physicians have received quality-related payments to date" and "physician attitudes about (pay-for-performance) range from skeptical to hostile," the center said. The barriers to successful programs include physicians' reluctance to submit to multiple performance-measurement sets, the difficulties in arriving at a consensus set and the prevalence of small group practices. Pay-for-performance programs "really only work for large practices" that have the required infrastructure, center President Paul Ginsburg said. Even in communities with a dominant payer, where it should be easier to arrive at a single measurement set, pay-for-performance has not been adopted, the center said. Read the issue brief.
Slow start to pay-for-performance
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