Pay for performance for the allergist-immunologist: Potential promise and problems

• Published in: Journal of allergy and clinical immunology Vol. 120; no. 4; pp. 769 - 775
• Main Authors: Schatz, Michael, MD, MS, Blaiss, Michael, MD, Green, George, MD, Aaronson, Donald, MD, JD, MPH
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.10.2007; Elsevier Limited
• Subjects: Allergy and Immunology; Allergy and Immunology - economics; Alliances; Ambulatory care; Asthma; Health care policy; Health maintenance organizations; HMOs; Hospitals; Humans; Medical research; Pay for performance; Physician Incentive Plans - economics; Physicians; practice management; Quality Assurance, Health Care - economics; quality measures; Quality of Health Care; Reimbursement, Incentive - economics; Risk Adjustment; United States; United States; United States > US; Partners Community Health Care, Inc; IHA; HEDIS; IOM; PCPI; Integrated Healthcare Association; HMO; Physician Consortium for Performance Improvement; Health maintenance organization; practice management; PCHI; Pay for performance; quality measures; Health Employer Data and Information Set; Institute of Medicine
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2007.05.048

Pay for performance is one component of a growing movement in this country to better align incentives so as to increase the quality of medical care and reduce unnecessary costs. The Physician Consortium for Quality Improvement is a national multistakeholder organization that is developing performance measures. Concerns regarding performance measures include technical concerns (eg, validity, risk adjustment, sample size, and accuracy considerations), concerns regarding the cost of implementation, and concerns regarding unintended consequences. Some data support the effectiveness of pay-for-performance programs, but more and better-designed studies are needed to rigorously assess the effectiveness of pay-for-performance programs. The Institute of Medicine 2006 report supports pay for performance “as a stimulus to foster comprehensive and system-wide improvements in the quality of healthcare.” This report also recommends that implementation of pay-for-performance programs should be carefully monitored to be sure that the stated goals are being achieved and that unintended consequences are recognized as early as possible. It is important for the allergist-immunologist to be an active participant in the evolving paradigm of pay for performance, advocating for the best interests of patients and providers alike.