Pay for performance off to a wobbly start

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CHICAGO—“Pay for performance (P4P) could produce unintended consequences,” cautioned Kimberly Applegate, MD, associate professor of radiology at Indiana University Riley Hospital for Children in Indianapolis, during a Monday afternoon focus session at the 94th annual meeting of the Radiological Society of North America (RSNA). Healthcare is complex and not well-aligned, making it nearly impossible to predict the impacts of a drastic overhaul like P4P.
Early studies hint at some troubling outcomes. Surveys of peer-reviewed studies show mixed results, said Bibb Allen, MD, chair of American College of Radiology commission on economics. Studies have not yet established a link between P4P and improved patient outcomes, and some indicate that P4P could limit access to care.
In addition to producing less than stellar clinical outcomes P4P has not yet benefited participating physicians. “Nearly half of all overall eligible bonus funds are left on the table,” shared Allen. Next year could see better results for radiologists as two more measures are reportable, and the Medicare bonus will increase from 1.5 to 2 percent.