|
Pay-for-performance is a controversial issue that is likely to get even more so as health providers and insurers accept the inevitability of the turn towards consumer-driven health, wherein Joe and Jane Public base their health choices on a raft of performance measures that rate hospitals and individual physicians on their ability to deliver various health services.
The back-and-forth over P4P has thrown out a natural enough question about just what do we mean when we talk about performance where health is concerned? For doctors it's a pretty involved question that goes right to their hearts -- or, at least, to their wallets -- since if someone gets it wrong then there's a potentially disastrous downside.
Those fears are beginning to be addressed. The American College of Physicians, for example, recently adopted a policy that assures doctors will have the opportunity to comment on any ratings they believe are inaccurate. That will help settle their minds about any potential revenue hit as well, the ACP insists, deliver more accurate comparisons on which the public can base their health choices.
That begs another question, however. Inherent in all of this stuff over P4P is that all the public needs is the information and then they can to go merrily off and make an educated decision.
Says who? Even if the medical profession can come up with performance metrics that everyone agrees accurately reflect how well doctors do their job, why should anyone assume they will mean anything to health consumers?
Sheldon Retchin, of Virginia Commonwealth University's School of Medicine, looks at what he terms "information asymmetry" in a recent article in the American Journal of Managed Care and comes up with an intriguing proposal.
Retchin says asymmetry -- what he defines as a gap in knowledge between consumers and professionals regarding healthcare price and quality -- is inherent in the marketplace, and makes it difficult for consumers to understand and interpret what performance metrics actually mean.
In fact, he claims that what few studies do exist now show that, even if such healthcare performance data is made available, most people don't have the health literacy to make much sense of them. That's why people traditionally depend on their doctor to make their health choices for them.
That strikes a chord. After all, providing that kind of background knowledge is basically why commercial outfits such as WebMD and Revolution Health exist and, they hope, will thrive.
Arguably, however, these are elitist sites which will attract an already educated and well-heeled crowd. Which is why Retchin's proposal for another class of healthcare professional he calls medical decision advisors, a cadre of formally trained, credentialed people whose purpose would be to explain just what the performance data meant and what choices consumers have, is appropriate.
Retchin thinks this might sound farfetched to some people, but I don't think so. Given the kind of vital decisions involved in healthcare, some kind of unbiased help should be provided for people in this brave new world of medicine.
What do you think?
By Brian Robinson, GHIT Contributing Writer
|
 |
|
There are currently no comments to display.
|
|
|
|
To post a comment you must be a registered user of GOVHEALTHIT.com and be logged in. Use one of the forms below to login or register for FREE to GOVHEALTHIT.com
|
|
|
|
