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P4P Demonstration Project: Results Encouraging Print E-mail
Written by Michael Casanova   
Sunday, 26 December 2010 00:00

    According to a Healthcare Finance News article, CMS reported year four results on its Pay-For-Performance (P4P) demonstration project, stating that the project has realized $98 million in savings, and its participants have qualified for more than $78 million in incentive payments.

As a result of this performance, CMS paid $31.7 million in performance payments to five physician groups. "Based on what we have learned so far, we know the healthcare industry can meet high standards for improving quality of care while saving Medicare money," said CMS Administrator Donald Berwick in a statement. "Now we want to raise the bar."

All that certainly sounds good, but other pundits point out that P4P schemes have unintended consequences that can potentially worsen health disparities for minorities and undermine their care if payments are not risk adjusted. In the article, two recent studies were cited.

For example, Johns Hopkins researcher Martin Makary, MD, found that physicians have more incentive to "pass on, stall or delay treatment" to obese patients in need of gallbladder or appendix surgeries because they're statistically more likely to experience complications than their non-obese counterparts. "We found that practices that treat vulnerable populations have room for performance improvement, so it's important to preserve the incentive to improve quality of care while taking steps to prevent an increase in disparities," said Dr. Mark Friedberg, the study's lead author. His study appears in the May issue of the journal Health Affairs.

As we continue to manage the current national fiscal crisis, expect healthcare to continue to dominate the news. Look for P4P schemes to be more focused toward case outcomes and not just cost-efficiency driven. 

About the Author:  Michael Casanova is a healthcare executive, consultant and author. Should you wish to opine, he can be reached at

Last Updated on Tuesday, 22 March 2011 16:56

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