Monday, November 19, 2007

Doctors, Plans, Doctors, Plans...

In an almost humourous move physicians today released a report card of their own: a report card ranking pay-for-performance plans in Minnesota. Coming from the very people who have been staunchly defending themselves against public reporting, this could seem a little tit-for-tat counter-intelligence style of guerrilla physician warfare, but the details are pretty cool.

The Minnesota Medical Association reviewed nine P4P programs and declared the system to be inconsistent, forcing docs to work to nine different tunes. Much of the problem lies in the fact that the health plans themselves don't have a standard way of measuring quality performance, which leads to docs having to chase their tails trying to meet performance objectives.

On a side note, I see again the concern that docs who treat "sicker" patients are unfairly measured as these populations should lead to risk adjustment for the physician.

I don't know about you, but if a medical society is willing to posit that Doctor A treats sicker people than Doctor B, I suggest that instead of grading Doctor A on a curve, we take the medical society at their word that Doctor A is not achieving good outcomes and get his "sicker" patients a better doctor who can actually handle the extra effort required.

If they're sicker, surely they should be getting better-than-standard care, not risk-adjusted average care? Call me crazy...
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