Pay For Performance Improves Outcomes

Health Care ReformPay for performance programs have been used in one form or another for the past two decades, usually as incentive payments to physicians who save the health care plan money. In the most recent decade, performance measures have tended to look at things like asthma control (fewer ER visits, better use of controller medications), decreased use of tests, radiology, and sub specialists, and for pediatricians, how well you vaccinate has been a major criteria of your quality of care. 

This study is refreshing in that they chose to look at measures that for the most part do reflect improved health: use of aspirin or anti-thrombotic prescriptions (no mention of alternative holistic approaches though), blood pressure control, cholesterol control (there exists some controversy whether or not this is the right measure of heart health), and smoking cessation.  Clearly if one quits smoking and has lower blood pressures you have improved that individual’s health.  The other measures are probably helpful too. 

If our health system will reward health care providers for real health improvements, and not measure parameters that are promoted by pharmaceutical or other interest groups, then we have a chance to really start turning our health care system around.  Let’s throw out all the assumptions and “facts” and look at just measurable health improvements like optimal weight, fitness, reduced blood pressure in adults with high blood pressure, fewer hospitalizations and ER visits, and any other measures that are simply measuring health.  

With the USA spending more on health than any other country but lagging behind almost 20 countries on most measures, it is time to move away from pharmaceutical based approaches and old paradigms, and take a fresh look at what really results in healthy children and adults.  Open the doors for real comparisons between those who practice mainstream approaches and those offering holistic and complimentary, integrative, or functional medicine approaches.  

This study has taken a step in the right direction. You can read the study here…


 Dr. Paul

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