Featured Research

from universities, journals, and other organizations

Properly designed pay-for-performance models can support medical professionalism

Date:
March 15, 2010
Source:
American College of Physicians
Summary:
An expert panel says that properly designed pay-for-performance (P4P) programs can strengthen the relationship between physicians and patients and increase the likelihood that physicians will deliver the best possible care.

An expert panel convened by the American College of Physicians (ACP) says that properly designed pay-for-performance (P4P) programs can strengthen the relationship between physicians and patients and increase the likelihood that physicians will deliver the best possible care. The panel's analysis appears in the March 16 issue of Annals of Internal Medicine.

Related Articles


"Concerns about the conflicts between medical professionalism and pay-for-performance have been based primarily on theories about the tension between external motivation and self-interest and the internal motivation and self-restraint that characterize professional expectations," said panel member Amir Qaseem, MD, PhD, MHA, FACP, a senior medical associate with ACP. "We believe that physicians should play a key role in defining and evaluating P4P programs that are compatible with professionalism."

The ACP-led panel of experts in clinical medicine, law, management, and health policy met six times to examine the relationship between medical professionalism (a code of conduct that under ideal circumstances is adhered to by all professionals) and P4P incentive programs (various financial incentive programs that differ in eligibility requirements, selection and scope of measures, formula for determining payment, and magnitude of payments).

Using the Charter on Medical Professionalism -- developed by the ACP Foundation, American Board of Internal Medicine Foundation, and European Federation of Internal Medicine -- as a framework, the panel organized the Charter's 10 professional responsibilities around four themes especially pertinent to P4P:

  • application of scientific evidence to deliver and improve care
  • ethically appropriate interactions between physicians and patients
  • promoting equity in health care delivery
  • commitment to the profession and its members

By systematically considering the potential interactions between P4P and each of the themes, the panel concluded the following:

  • Medical professionalism rests on the integrity of scientific standards grounded in research evidence and the translation of evidence into practice guidelines, which define the proper use and implementation of diagnostic testing and therapeutics. A P4P incentive should be linked to carefully specified, evidence-based measures of the process of care, because such measures can drive the delivery of care to conform to scientific evidence. Inadequately risk-adjusted measures that do not recognize the severity or complexity of a patient's condition may lead physicians to avoid patients with severe or complex illness (cherry picking). The scientific evidence must be protected from inappropriate influence by nonprofessionals or others who have a direct financial interest in a particular definition of a standard or guideline or in a performance measure based on one.
  • Ethical interactions encompass honesty with patients, maintaining the confidentiality of patient information, avoiding improper relationships that take advantage of the patient's vulnerability, and avoiding conflicts of interest. Transparency of quality measurement and disclosure of payment incentives may enhance patient trust. The point of P4P programs is to create a financial incentive that aligns the interests of physicians and patients, and this can often motivate both increased use of preventive services and improved care management.
  • Medical professionalism envisions an equal standard of care for all patients. Pay-for-performance programs are unlikely to foster the equitable distribution of care unless they include measures of access to care and adequate case-mix and risk adjustment strategies. Measuring variability in the allocation of patients among providers enables adjustment of scoring and performance rewards based on the complexity of patient socioeconomic and clinical case-mix of a provider group.
  • Pay-for-performance programs that pay only on the basis of the top tier of performance put physicians in competition with each other. P4P programs could be designed to encourage the sharing of knowledge, scientific evidence, and information -- a principle of professionalism.

The American College of Physicians position paper is titled Pay-for-Performance Principles that Ensure the Promotion of Patient Centered Care.


Story Source:

The above story is based on materials provided by American College of Physicians. Note: Materials may be edited for content and length.


Cite This Page:

American College of Physicians. "Properly designed pay-for-performance models can support medical professionalism." ScienceDaily. ScienceDaily, 15 March 2010. <www.sciencedaily.com/releases/2010/03/100315172211.htm>.
American College of Physicians. (2010, March 15). Properly designed pay-for-performance models can support medical professionalism. ScienceDaily. Retrieved October 30, 2014 from www.sciencedaily.com/releases/2010/03/100315172211.htm
American College of Physicians. "Properly designed pay-for-performance models can support medical professionalism." ScienceDaily. www.sciencedaily.com/releases/2010/03/100315172211.htm (accessed October 30, 2014).

Share This



More Health & Medicine News

Thursday, October 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Mind-Controlled Prosthetic Arm Restores Amputee Dexterity

Mind-Controlled Prosthetic Arm Restores Amputee Dexterity

Reuters - Innovations Video Online (Oct. 29, 2014) A Swedish amputee who became the first person to ever receive a brain controlled prosthetic arm is able to manipulate and handle delicate objects with an unprecedented level of dexterity. The device is connected directly to his bone, nerves and muscles, giving him the ability to control it with his thoughts. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Google To Use Nanoparticles, Wearables To Detect Disease

Google To Use Nanoparticles, Wearables To Detect Disease

Newsy (Oct. 29, 2014) Google X wants to improve modern medicine with nanoparticles and a wearable device. It's all an attempt to tackle disease detection and prevention. Video provided by Newsy
Powered by NewsLook.com
Can Drinking Milk Lead To Early Death?

Can Drinking Milk Lead To Early Death?

Newsy (Oct. 29, 2014) Researchers in Sweden released a study showing heavy milk drinkers face an increased mortality risk from a variety of causes. Video provided by Newsy
Powered by NewsLook.com
Obama: The US Will Not 'run and Hide' From Ebola

Obama: The US Will Not 'run and Hide' From Ebola

AP (Oct. 29, 2014) Surrounded by health care workers in the White House East Room, President Barack Obama said the U.S. will likely see additional Ebola cases in the weeks ahead. But he said the nation can't seal itself off in the fight against the disease. (Oct. 29) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



    Save/Print:
    Share:

    Free Subscriptions


    Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

    Get Social & Mobile


    Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

    Have Feedback?


    Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
    Mobile: iPhone Android Web
    Follow: Facebook Twitter Google+
    Subscribe: RSS Feeds Email Newsletters
    Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins