tci Medicare Compliance & Reimbursement - 2005 Issue 12

Coverage: Providers Still Wary of P4P System

Most payers feel system must be mandatory to work.MedPAC, private insurers, CMS, many health-policy analysts, and even members of Congress are endorsing pay-for-performance (P4P). In general, people who pay for health care see pay-for-performance as a way of directing $2 trillion in annual U.S. spending toward care that has high value and is delivered efficiently. Would P4P be mandatory? Of course, say payers. Otherwise, those who can't or won't meet standards simply wouldn't play, and determining whether their care delivers adequate value for the dollar would be impossible.Yet to be convinced, however, are many providers. For...

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