Merit pay for doctors | Arkansas Blog

Saturday, January 12, 2013

Merit pay for doctors

Posted By on Sat, Jan 12, 2013 at 6:47 AM

If it's good enough for teachers, why not for doctors?

Arkansas is moving toward a different scheme of reimbursing health care providers related to a continuum of care and positive results rather than a strict fee-for-service model.

But the NY Times reports that New York city is moving that idea even farther along:

In a bold experiment in performance pay, complaints from patients at New York City’s public hospitals and other measures of their care — like how long before they are discharged and how they fare afterward — will be reflected in doctors’ paychecks under a plan being negotiated by the physicians and their hospitals.

... And it is unclear whether performance incentives work in the medical world; studies of similar programs in other countries indicate that doctors learn to manipulate the system.

... The public hospital system has come up with 13 performance indicators. Among them are how well patients say their doctors communicate with them, how many patients with heart failure and pneumonia are readmitted within 30 days, how quickly emergency room patients go from triage to beds, whether doctors get to the operating room on time and how quickly patients are discharged.

Inevitably, the quality of patient a doctor treats might have some impact in the equation, seems like. If every child can achieve an arbitrary performance standard, every patient can get better, right?

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