“Pay for Performance” (P4P, sometimes called “Pay for Play” by some of us who aren’t fond of the scheme) just got a huge boost from Congress. Expect to see more docs carrying computers equipped to run an “electronic medical record” (EMR) around the office.
And don’t be surprised to see more solo and small group practices withdraw from participation with Medicare and insurance companies, merge with ever-bigger groups or close down completely as the docs find other ways to make a living.
The current lines of EMR cost $50,000 per doc or “provider” to start, and can cost $8000 or so each year for up keep. (I have no idea why, but that’s what I hear.) And EMR’s will be necessary in order to charge for the work that the doc does in the near future.
Initially, the scheme will measure the doc’s ability to report data, more than any health benefits. From today’s Wall Street Journal, subscription only:
This is clearest in Medicare, the federal health program that covers more than 40 million elderly and disabled people. Congress agreed to erase a scheduled reduction in payments to physicians, but it made a 1.5% bonus payment available only to physicians who report to Medicare how they perform on certain specified barometers of health-care quality. Initially, the payments will be based on whether the physician reports the data, but the system lays the groundwork for higher payments to better-performing physicians.
Among the information Medicare officials will collect: whether doctors provide aspirin and beta blockers to patients having heart attacks, and whether elderly patients are screened for their risk of falls. These practices are considered indicators of good patient care.