P4P coming to radiology soon
CHICAGO, Nov. 26—The current reimbursement system doesn’t reward quality or punish poor performance, said Bruce Reiner, MD, of the VA Maryland Health Care System in Baltimore, during his session titled “Using Information Technology to Document Your Value” presented at the 93rd annual meeting of the Radiological Society of North America (RSNA).

Plus, inflationary pressures put greater emphasis on cost than quality. Pay for performance (P4P) is the use of incentives to encourage the delivery of evidence-based medicine practices.
The Institute of Medicine (IOM) has called for sweeping reform of the healthcare system and recently created a P4P subcommittee. The organization has listed the following as goals for P4P systems: safety, effectiveness, patient centricity, timeliness, efficiency and equity. In 2001, the IOM recommended financial incentives based on evidence-based medicine and improved outcomes.

In the United States, two times as much per capita is spent on healthcare as in other countries. Reiner said that studies have shown that up to 7 percent of imaging studies performed are redundant. So, just a 1 percent decrease in repeat exams would save $92 million.

The benefits of P4P to physicians include automated data extraction for outcomes analysis, financial payments, and automated alerts and recommendations.

Reiner said the healthcare field needs to create quality performance metrics that enlist industry support to tie quality performance metrics to imaging modalities. For example, why should a radiologist get the same pay for both 1.5T and 3T magnet studies? His other recommendations include the support of standardization and integration of referenceable databases, tracking quality assurance (QA) performance from patients’ point of view, tying malpractice rates to individual QA rates, and tying reimbursement to the practice of evidence-based medicine.

Right now, P4P is focused on primary care, Reiner said, but “it will affect radiology and IT in the near future.”