MMA releases Pay for Performance report

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MINNEAPOLIS, November 19, 2007—The Minnesota Medical Association published a report Monday examining and evaluating Minnesota's pay for performance programs.

MMA Member Benjamin Whitten, M.D., talks about pay-for-performance during this Kare11 report. Click to view. RealPlayer required. (2:30)

"In order to improve health care quality," the report begins, "insurers, purchasers, and policymakers are increasingly using financial incentives to reward physicians and medical groups that meet specific performance goals. Although research on the efficacy of these pay-for-performance (P4P) programs to improve the quality of care is increasing, there is little evidence about their value that is statistically significant or convincing."

The MMA report urges Minnesota’s health plans, employers and others that use pay-for-performance programs to take the following steps:

Adopt a common measurement set, preferably one developed by MN Community Measurement, and a streamlined data collection process in order
to reduce the administrative burden; (This would help reduce health care costs and give physicians more time to spend with their patients.)
Provide financial incentives for care coordination, especially for patients with chronic illnesses;
Provide financial incentives for implementing health information technology and electronic medical records;
Eliminate financial penalties for providing care that is in the patient’s best interest; (A physician shouldn’t be penalized for prescribing a brand-name
drug rather than a generic if that’s what the patient needs.)
Ensure that programs don’t penalize physicians who accept patients with complex and difficult conditions.

The MMA examined the various health plans and government programs and evaluated their pay-for-performance programs on how well they meet the MMA’s criteria for effective incentives programs — driving improvements in quality care strengthening the physician-patient partnership, including physicians across medical specialties and using valid measures.

One shortcoming noted in the report is that Minnesota’s pay-for-performance programs rarely adjust for differences in the severity and complexity of the patients’ condition. This can result in an apples-to-oranges comparison that doesn’t really capture differences in the care provided, the report said.