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HomeLast Word → Pay-for-performance: a dangerous health policy fad that won't die

Pay-for-performance: a dangerous health policy fad that won't die Print E-mail
Written by Kip Sullivan, Stephen Soumerai | STAT First Opinion   
Thursday, 01 February 2018 00:00

Pay-for-performance, the catchall term for policies that purport to pay doctors and hospitals based on quality and cost measures, has been taking a bashing. Last November, University of Pittsburgh and Harvard researchers published a major study in Annals of Internal Medicine showing that a Medicare pay-for-performance program did not improve quality or reduce cost and, to make matters worse, it actually penalized doctors for caring for the poorest and sickest patients because their "quality scores" suffered. In December, Ankur Gupta and colleagues reported that a Medicare program that rewards and punishes hospitals based on arbitrary limits on the number of hospital admissions of heart failure patients may have increased death rates. On New Year's Day, the New York Times reported that penalties for "inappropriate care" concocted by Veterans Affairs induced an Oregon hospital to deny acute medical care to its sickest patients, including an 81-year-old "malnourished and dehydrated" vet with skin ulcers and broken ribs.

 


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