Physician Pay Will Soon Depend on Outcomes
But patient outcomes are already a pay-for-performance measure for hospitals, which are blamed and penalized for performance on excessive readmissions. Starting Oct. 1, 2014, they'll be penalized for higher rates of 30-day mortality for three diseases/conditions, and for central line bloodstream infections, and for a composite of never events such as pressure ulcers and blood clots.
Doctors now will have their turn to share the responsibility and the financial risk for keeping patients healthy and out of the hospital.
Bagley and many other physician leaders I've spoken with don't dispute that measurement should move from being primarily process-based to primarily outcomes-based. Eventually.
But whether doctors should be measured alone, or in group practices, and by how many measures remains in dispute.
Now, in sessions that are probably filled with acrimony and tension, professional societies and registries are trying to come up with outcome measures that fairly reflect their procedural services, and distinguish good performers from those who might be better off finding another line of work.
"The American College of Cardiology has a good measurement strategy and a good registry of outcomes for a large population of their members. They have this stuff figured out," Bagley says. "But that's not the case for other specialties."
For example, he says, "Think about the ear, nose, and throat doctor. We have some measures around otitis externa and sinusitis. But that doesn't come close to the range of things they do every day."
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