Why Docs are 'Constantly Encouraged to Do Bad'

Joe Cantlupe, August 22, 2013

The motivation to properly care for patients "has been sapped by poorly designed incentives," one economist says. Pay-for-performance models, capitation, and bundled payments "often fall short of their goals and must be re-examined."

As healthcare organizations evaluate payment models, the role of physicians is central to where hospitals and health systems want to go and how they will improve the quality and efficiency of care.

But can providers effectively stop doctors from performing too many needless tests? Can they engage with physicians and give them proper rewards? Can patient care be improved, with a proper cost structure for all types of care and disease states? Will the move from fee-for-service to value-based care work?

Will physicians be "motivated" to achieve healthcare's goals, for population health?

"We're continuing to try to come up with some mix that is going to push the doc in this direction or that," says Francois de Brantes, an economist and executive director of the Health Care Incentives Improvement Institute. "You know the tension with docs has been, 'I'm not paid to do X, I'm paid to do Y,'' de Brantes says. "So we're moving from fee-for-service. OK, what's next? We aren't totally focused, yet people say everything is cool, and everything is going to be great."

Joe Cantlupe Joe Cantlupe is a senior editor with HealthLeaders Media Online.Twitter


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