Navigation Links
Health-care reform should start with paying evidence-based financial incentives to doctors

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
Cedars-Sinai Medical Center

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:
(Date:6/25/2016)... TX (PRWEB) , ... June 25, 2016 , ... ... the United States, named Dr. Sesan Ogunleye, as the Medical Director of its new ... the facility Medical Director of our new Mesquite location,” said Dr. James M. Muzzarelli, ...
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the ... In terms of the latter, setting the bar too high can result in disappointment, ... just slow progress toward their goal. , Research from reveals ...
(Date:6/24/2016)... ... ... a crisis. Her son James, eight, was out of control. Prone to extreme mood shifts ... upset him, he couldn’t control his emotions,” remembers Marcy. “If there was a knife ... and say he was going to kill them. If we were driving on the ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San Diego, CA is excited ... To Recovery® program to drive cancer patients to and from their cancer treatments. ... highest quality of life and ongoing independence. Getting to and from medical treatments ...
(Date:6/24/2016)... ... June 24, 2016 , ... The Haute ... Dr. Barry M. Weintraub as a prominent plastic surgeon and the network’s newest ... world, and the most handsome men, look naturally attractive. Plastic surgery should be ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)...  MedSource announced today that it has selected ... of choice.  This latest decision demonstrates MedSource,s commitment ... clients by offering a state-of-the-art electronic data capture ... as the EDC platform of choice in exchange ... has long been a preferred EDC platform by ...
(Date:6/23/2016)... Calif. , June 23, 2016 Any dentist ... many challenges of the current process. Many of them do ... of the technical difficulties and high laboratory costs involved. And ... to offer it at such a high cost that the ... it. Dr. Parsa Zadeh , founder of ...
(Date:6/23/2016)... 2016  In a startling report released today, National Safety ... lacking a comprehensive, proven plan to eliminate prescription opioid overdoses. ... how states are tackling the worst drug crisis in recorded U.S. ... Kentucky , New Mexico , ... Of the 28 failing states, three – Michigan ...
Breaking Medicine Technology: