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Clinical Practice Guidelines for Older Patients With Comorbid Diseases
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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To the Editor: In their Special Communication, Dr Boyd and colleagues1 argue that strict adherence to CPGs for populations with multiple comorbid diseases could have detrimental effects, a problem that could be exacerbated by linking pay to CPG adherence. However, CPGs could be used to establish a clinically relevant payment system. The current fee-for-service system does not reflect the evidence-based resource requirements to appropriately manage diseases. A payment system shaped by CPGs could base payments on evidence-based, clinically appropriate resources, thus creating an immediate incentive to reduce both overuse and underuse.
Such a payment model is being designed by Bridges to Excellence,2 a multistakeholder group. In this model, physicians and payers would agree on the selection of specific CPGs; initially, patients with multiple complex conditions would be excluded. The payment amount would be based on resources required to deliver the services recommended in the chosen CPG. Physicians who are contracted . . . [Full Text of this Article]
Francois de Brantes, MBA
francois.debrantes@ge.com General Electric Company Fairfield, Conn
Alice G. Gosfield, JD
Alice G. Gosfield & Associates Philadelphia, Pa
Elizabeth McGlynn, PhD
RAND Corp Santa Monica, Calif
Meredith Rosenthal, PhD
Harvard School of Public Health Boston, Mass
Jeffrey Levin-Scherz, MD
Partners Community Health Care Inc Boston, Mass
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