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:10/13/2017)... ... October 13, 2017 , ... The Visiting Nurse Association (VNA) ... a collection of specialty vendors and unique items from across the nation, this holiday-themed ... and wellness services offered by the VNA. The boutique will be open Saturday, ...
(Date:10/13/2017)... ... 13, 2017 , ... Talented host, actor Rob Lowe, is ... a new episode of "Success Files," which is an award-winning educational program broadcasted ... each subject in-depth with passion and integrity. , Sciatica occurs when the sciatic ...
(Date:10/12/2017)... ... October 12, 2017 , ... First Healthcare Compliance (FHC), an ... showcase a range of technology and learning solutions at the 68th Annual American ... to be held October 14–18, 2017 at the Mandalay Bay Resort in Las ...
(Date:10/12/2017)... PALM CITY, Fla. (PRWEB) , ... October 12, 2017 , ... ... of cold therapy products, announced today the introduction of an innovative new design of ... the multipurpose pad so you get maximum comfort while controlling your pain while using ...
(Date:10/12/2017)... ... October 12, 2017 , ... ... has recently contributed a medical article to the newly revamped Cosmetic Town ... article spotlights the hair transplant procedure known as Follicular Unit Extraction ...
Breaking Medicine News(10 mins):
(Date:9/18/2017)... Sept. 18, 2017 EpiVax, Inc. ... bioinformatics and immune engineering, today announced a ... A (H7N9) vaccine. ... seasonal influenza and presents a challenge for ... exposure to be effective. Using state-of-the-art bioinformatics and ...
(Date:9/12/2017)... NEW YORK , Sept. 12, 2017   EcoVadis , the ... chains, has published the first annual edition of its Global CSR Risk ... 20,400 companies evaluated by EcoVadis, based on Scorecard Ratings that analyzed nearly ... ... Performance Index ...
(Date:9/12/2017)... , Sept. 12, 2017  ValGenesis Inc., ... Solutions (VLMS), is pleased to announce the appointment ... member of its Board of Directors and Chairman ... VLMS enables life science companies to manage their ... use of paper in this process. Furthermore, ValGenesis ...
Breaking Medicine Technology: