Health insurer efforts to measure and report the quality of doctors and hospitals are in their infancy.
A PricewaterhouseCoopers L.L.C. team led a health industries specialist in the firm’s McLean, Va., office have come to that conclusion in a study based on a review of 10 established “pay for performance” programs.
The federal government wants to make “P4P” compensation a standard part of government health finance programs, but a review of the existing private-sector P4P efforts shows that if “you’ve seen one pay-for-performance program…you’ve seen one pay-for-performance program,” the PricewaterhouseCoopers researchers write.
The companies use about 60 indicators to measure performance, but no single indicator is used by all 10 plans, the researchers report.
Only 1 plan looked at whether doctors helped smokers to quit smoking, and only 1 looked at patients’ satisfaction with their level of access to a physician.
Despite reports of New York regulators expressing concern about performance-based compensation systems, most carriers seem to be leery about creating “tiered” provider networks or taking other aggressive steps to steer patients toward higher-rated providers, the researchers report.
In many cases, the payment system is so broken down that P4P programs seem to be “putting lipstick on a pig,” industry players told the researchers.