Navigation Links
Health-care reform should start with paying evidence-based financial incentives to doctors
Date:4/20/2009

Healthcare Reform should start with "evidence-based reimbursement", structuring physician payment incentives around existing empirical evidence of clinical benefit, which would improve quality and reduce the cost of healthcare, says a commentary written by two cardiologists and published in Circulation: Cardiovascular Quality and Outcomes.

For example, some 500,000 U.S. patients suffering from mild chest pain due to coronary artery disease undergo balloon angioplasty or percutaneous coronary intervention (PCI) every year, a procedure that costs approximately $20,000 per patient, for a total U.S. expenditure of $10 billion a year. However, empirical studies document that 10 percent-20 percent of PCI patients are asymptomatic, only 50 percent have undergone a stress test to determine the severity of their disease and as many as 30 percent aren't taking prescription heart medications that, for patients with mild coronary artery disease, could be just as effective as PCI.

The authors cite a recent COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive drug Evaluation) trial which followed 2,000 patients with mild to moderate chronic stable angina. All patients received optimal medical therapy. Half of the patients also underwent angioplasty. The patients received follow-up care for 4.6 years, but there was no significant difference between the groups in the mortality rate.

As an example of Evidence-based Financial Incentives, the authors propose that physicians of the patients who undergo PCI be paid on a sliding scale, from $8,000 to $24,000, with the highest payments going to the physicians of patients with the most severe symptoms because the sickest patients receive the most benefit from the procedure.

WHO: George Diamond, M.D., a senior research scientist, emeritus and Sanjay Kaul, M.D., director of the Cardiology Fellowship Training Program and director of the Vascular Physiology and Thrombosis Research Laboratory in the Division of Cardiology at the Cedars-Sinai Heart Institute.

"A lot of care isn't tied directly to proof of patient benefit in clinical trials," Diamond said. "It's not that the care is wrong. It's not documented to be of value. And if it's not documented to be of value, then it should be worth less. The purpose is not to deny anybody of healthcare, but rather to funnel them to the best proven care alternatives."

RAMIFICATIONS: Diamond and Kaul suggest empirical data could be used to determine how much physicians would be paid by Medicare and private insurers for performing specific procedures. They hope to prompt a discussion of "evidence-based reimbursement incentives" rather than "pay for performance" among the public and policy makers. President Barack Obama has called for a national discussion of healthcare reform in the fall of 2009.


'/>"/>

Contact: Sally Stewart
Sally.stewart@cshs.org
310-248-6566
Cedars-Sinai Medical Center
Source:Eurekalert

Related medicine news :

1. New Mexican health-care program successful at reducing crippling health care costs
2. Health-Care Costs Go Up, and Stay Up, for Abused Women
3. With Alzheimers, Health-Care Costs Could Triple
4. Prioritizing health-care reform components
5. Skyrocketing Health-Care Costs Could Double Premiums for Many Americans
6. Skyocketing Health-Care Costs Could Double Premiums for Many Americans
7. Vivisimo Search Delivers Medical Knowledge to Global Health-Care Community
8. UT public health policy expert says US can learn from Dutch universal health-care coverage
9. Condell Health Network and Medical Center to Pay $36 Million Settlement After Self-Reporting Possible Health-Care Fraud
10. Adalimumab may reduce health-care costs for Crohns disease patients
11. Health-care barriers for undocumented immigrants: Raising tuberculosis risk?
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... , ... The temporary closing of Bruton Memorial Library on June 21 due to a possible ... often overlooked aspect of head lice: the parasite’s ability to live away from a human ... but a necessary one in the event that lice have simply gotten out of control. ...
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... On Friday, ... presented a Bronze Wellness at Work award to iHire in recognition of their exemplary ... part of the 7th annual Maryland Workplace Health & Wellness Symposium at the BWI ...
(Date:6/24/2016)... ... ... crisis. Her son James, eight, was out of control. Prone to extreme mood shifts and ... him, he couldn’t control his emotions,” remembers Marcy. “If there was a knife on ... say he was going to kill them. If we were driving on the freeway, ...
(Date:6/24/2016)... ... , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway Pain Relief Products, join The ‘Business ... to $12 an hour by 2020 and then adjusting it yearly to increase at the ... minimum wage, assure the wage floor does not erode again, and make future increases more ...
(Date:6/24/2016)... ... June 24, 2016 , ... Strategic Capital ... area economy by obtaining investment capital for emerging technology companies. SCP has ... have already resulted in more than a million dollars of capital investment for ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016  In a startling report released today, ... their residents by lacking a comprehensive, proven plan to eliminate prescription ... definitive ranking of how states are tackling the worst drug crisis ... four states – Kentucky , New ... Vermont . Of the 28 failing states, three – ...
(Date:6/23/2016)... Research and Markets has announced the addition of the ... to 2022" report to their offering. ... financial data derived from varied research sources to present unique ... on the market during the next five years, including a ... markets, regional and country level analysis. The report provides a ...
(Date:6/23/2016)... 23, 2016 Research and Markets has ... 52" report to their offering. ... creates a favourable commercial environment for MedImmune to enter. The ... that will serve to drive considerable growth for effective anti-influenza ... to cap sales considerably, but development is still in its ...
Breaking Medicine Technology: