A Pay-for-Population Health Performance System
- David A. Kindig, MD, PhD
- Author Affiliation: Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison.
- Corresponding Author: David A. Kindig, MD, PhD, Department of Population Health Sciences, University of Wisconsin, 610 Walnut Room, 760 WARF, Madison, WI 53726 (dakindig{at}wisc.edu).
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- COSTS AND COST ANALYSIS
- HEALTH POLICY
- POPULATION
- PUBLIC HEALTH
- REIMBURSEMENT MECHANISMS
- UNITED STATES
The report Rewarding Provider Performance,1 recently released by the Institute of Medicine, concludes that early experience with pay-for-performance has been promising and recommends that Medicare begin to phase in this strategy to foster comprehensive and system-wide improvements in the quality of health care. Even though the effectiveness of pay-for-performance in medical care has been evaluated in fewer than 20 studies and the conclusions on its impact have been mixed, the need for reform is so great that beginning to move cautiously in this direction has been endorsed by the panel involved in the Institute of Medicine's report.
But improvements in the quality of health care alone will be inadequate to significantly improve population health. A decade ago I asserted that “population health improvement will not be achieved until appropriate financial incentives are designed for this outcome”2 and proposed a 20-year timetable, which would begin with pay-for-performance in medical …
