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)... ... 13, 2017 , ... ProVest Insurance Group, a family managed ... Raleigh regions, is organizing an extended charity drive to benefit the family of ... , After struggling since birth with several health challenges, T.J. was later diagnosed ...
(Date:10/13/2017)... ... ... The American Board of Family Medicine's (ABFM) Board of Directors has selected Warren ... James C. Puffer upon his retirement. Dr. Newton will serve in the position of ... end of 2018. Upon assuming the role of President and CEO on January 1, ...
(Date:10/13/2017)... ... October 13, 2017 , ... Lori R. Somekh, founder of ... ElderCounsel, a national organization of elder law and special needs planning attorneys. “Membership in ... It also provides a forum to network with elder law attorneys nationwide,” said Somekh. ...
(Date:10/13/2017)... ... 13, 2017 , ... Ellevate Network, the leading network for professional women, brought ... gender equality at their inaugural Summit in New York City in June. The event ... audience of over 3 million. To watch the Mobilize Women video, click here ...
(Date:10/13/2017)... ... 13, 2017 , ... Coveros, a leader in agile coaching ... contract by the Center for Medicare and Medicaid Services (CMS). The Enterprise Agile ... of Agile methodologies in a consistent and high value manner across CMS programs. ...
Breaking Medicine News(10 mins):
(Date:10/12/2017)... , Oct. 12, 2017 AVACEN Medical ... the company with their  2017 New Product Innovation Award ... on extensive primary and secondary medical device market research by ... through its first-to-market OTC, drug-free pain relief product, the AVACEN ... approach to treating fibromyalgia widespread pain. ...
(Date:10/11/2017)...  True Health, a leader in integrated diagnostics ... National Breast Cancer Awareness month to educate doctors ... Research recently published in ... than 10 million American women are at significant ... BRCA2 and have not had testing. These mutations can ...
(Date:10/5/2017)... , Oct. 5, 2017  In response ... of Oral and Maxillofacial Surgeons (AAOMS) released prescribing ... – to be used as a first-line therapy ... Recognizing the ... AAOMS White Paper "Opioid Prescribing: Acute and Postoperative ...
Breaking Medicine Technology: