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ATS endorses pay-for-performance for pulmonary, critical care and sleep medicine
Date:3/24/2010

urage "patient dumping" or "cream skimming," as healthcare providers seek to minimize their risk of financial losses or optimize their financial gains.

To reduce the likelihood of such problems arising, the ATS endorses a stratification of performance measurements by high-risk groups, which would specifically target underserved and at-risk populations so as to provide financial rewards for clinicians who care for such vulnerable patients.

"Performance improvement must remain the central tenet of P4P and performance is defined by the degree to which these initiatives promote the delivery of high-quality patient care," said Dr. Heffner.

Furthermore, he noted, "P4P must never degrade the healthcare team, its interdisciplinary nature, or the autonomy and service orientation of providers, all of which are essential for providing high-quality care. Hospitals and physicians should establish mechanisms to reward nurses, respiratory therapists, pharmacists, nutritionists and other healthcare professionals who might not benefit from rewards to physicians for high performance under existing reimbursement structures."

The statement also emphasizes that more research must be done on P4P, particularly to evaluate its effectiveness, the organizational, structural and cultural factors that may influence its success, and its ability to increase access to healthcare and improve outcomes. In all cases, the cost-effectiveness of a program must always be monitored.

"P4P programs are likely to expand in the coming years. Indeed, linking reimbursement to quality is a central tenet of the recent healthcare reform measures passed by the United States Congress," said Dr. Kahn. "Through this statement, the ATS endorses the concept of P4P and offers a framework for its members to work with healthcare administrators and policy makers to develop these programs."


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Contact: Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

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