Briefing Detail Page
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 Pay-for Performance and Medicare: Moving from the Drawing Board to the Doctor's Office
Friday, December 15, 2006
As the nation’s largest payer for health care services, the Medicare program has a major effect on payments to providers. Its ability to align incentives through pay-for-performance will have implications for the health delivery system at large. A recent Institute of Medicine report made recommendations for implementation of “P4P” under Medicare.
Proper implementation will require among many other things, assessment of the adequacy of clinical measures, implementation and improvement of health information technology, and increased provider compliance with public reporting requirements.
What have been the results of recent Medicare P4P provider demonstration projects? How was the effectiveness of pay-for-performance measured in those demonstrations? Is pay-for-performance a workable model for all Medicare providers? If so, how much funding would be required to implement P4P more broadly and where would such funding come from? What types of P4P efficacy measures would be necessary going forward? Will Congress need to more permanently address the Medicare physician payment formula in order for doctors to buy into pay-for-performance?
To discuss these and related questions, The Commonwealth Fund and the Alliance for Health Reform sponsored a December 15 briefing. Panelists were: Robert Berenson, the Urban Institute; Robert Galvin, General Electric; Alan Nelson, The American College of Physicians; and Gail Wilensky, Project HOPE. Ed Howard of the Alliance moderated the discussion.
| Speakers |
Robert Galvin, General Electric Global Health Company, Speaker
Robert Berenson, Urban Institute, Speaker
Alan Nelson, The American College of Physicians, Speaker
Gail Wilensky, Project HOPE, Speaker
Ed Howard, Alliance for Health Reform, Moderator
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| Transcript, Event Summary and/or Webcast and Podcast |
Transcript: Transcript: Pay-for-Performance and Medicaid: Moving from the Drawing Board to the Doctor's... (Adobe Acrobat PDF), 12/15/2006
Full Webcast/Podcast: Webcast: Pay-for-Performance and Medicare: Moving from the Drawing Board to the Doctor's Office
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| The transcript, full webcast and podcast for this briefing are provided by Kaiser Family Foundation.
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| Speaker Presentations |
Wilensky's Presentation: Pay-for-Performance and Medicare (Adobe Acrobat PDF), 12/15/2006
Nelson's Presentation: Pay-for-Performance and Medicaid (Adobe Acrobat PDF), 12/15/2006
Berenson's Presentation: Pay-for-Performance and Medicaid (Adobe Acrobat PDF), 12/15/2006
(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)
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| Source Materials |
Rewarding Performance in Medicaid Managed Care (Adobe Acrobat PDF), Center for Health Care Strategies, Inc. (CHCS), 3/1/2006
Pay for Performance: A Decision Guide for Purchasers (Adobe Acrobat PDF), Agency for Healthcare Research and Quality, 4/1/2006
Letter from CMS (Adobe Acrobat PDF), Center for Medicare and Medicaid Services, 4/5/2006
Performance Incentive Programs- Chart pack (Adobe Acrobat PDF), Center for Health Care Strategies, 4/1/2006
CRS Report for Congress: Pay-for-performance in Health Care (Adobe Acrobat PDF), Congression Research Service (CRS), 12/12/2006
Rewarding Provider Performance: Aligning Incentives in Medicare (Adobe Acrobat PDF), IOM, 9/1/2006
Medicare Physician Payment: Are We Getting What We Pay For? Testimony (Adobe Acrobat PDF), The Commonwealth, 7/25/2006
TL: Early Experience with Pay-for-Performance: From Concept to Practice (Adobe Acrobat PDF), Journal of the American Medical Association, 10/12/2006
Examining Pay-for-Performance Measures and Other Trends in Employer-Sponsored Health Care (Adobe Acrobat PDF), The Commonwealth Fund, 5/1/2006
Health Care Leaders: Pay-for-Performance Most Effective Way to Reduce Health Car (Adobe Acrobat PDF), The Commonwealth Fund, 5/13/2005
ITL: Will Physician-Level Measures of Clinical Performance Be Used in Medical Malpractice Liti (Adobe Acrobat PDF), Journal of the American Medical Association, 4/19/2006
PROMETHEUS: Provider Payment for High Quality Care: A White Paper- Executive Summary (Adobe Acrobat PDF), Prometheus, 5/1/2006
Hospital Quality Initiative Overview (Adobe Acrobat PDF), CMS, 12/1/2005
Hospital Quality Alliance: Improving Care Through Information (Adobe Acrobat PDF), CMS, 11/22/2005
Reporting Hospital Quality Data for Annual Payments Update (RHQDAPU) (Adobe Acrobat PDF), CMS, 1/1/2006
Center for Medicare and Medicaid sercives (CMS)/ Premier Hospital Quality and incentive Demonst (Adobe Acrobat PDF), Premier, 4/13/2006
The Medicare Care Management Performance Demonstration (Adobe Acrobat PDF), CMS, 11/1/2005
ESRD Disease Management Demonstration Fact (Adobe Acrobat PDF), CMS, 10/17/2006
Sourcelist: Pay for Performance (Word Document), Alliance for Health Reform, 12/15/2006
Speaker Biographies: Pay-for-Performance and Medicaid (Adobe Acrobat PDF), Alliance for Health Reform, 12/15/2007
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| Offsite Materials (briefing documents saved on other websites) |
CEO Survival Guide to Pay for Performance- Executive Summary, QNF Executive Institute, 1/1/2006
Pay-for-Performance, Center for Health Care Strategies, Inc., 7/1/2006
Creating Accountable Care Organizations: The Extended Hospital Medical Staff, Health Affairs, 12/5/2006
Prometheus’ new payment model seeks to reform the toxic health care payment system, The Leapfrog group, 9/1/2006
Bill H.R.6804- Tax Relief and Health Care Act of 2006 (Introduced in House), Library of Congress- Thomas, 12/7/2006
Opening Doors on Disease Management, HealthDecisions.org – Health Savings Accounts, 8/16/2006
CEO Survival Guide to Pay-for-Performance: Overview of CMS Demonstration Projects, NQF Executive Institute, 1/1/2006
Medicare Links Doctors’ Pay to Practices, The New York Times, 12/12/2006
Quality Matters: Pay-for-Performance in Medicare, The Commonwealth Fund, 9/1/2006
Recalibrating Medicare Payments for Inpatient Care, New England Journal of Medicine, 11/26/2006
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Robert Berenson, senior fellow at the Urban Institute -- speaker at the December 15th briefing cosponsored by The Commonwealth Fund. |
Robert Galvin, director of Gobal Healthcare for General Electric -- speaker at the December 15th briefing cosponsored by The Commonwealth Fund. |
Alan Nelson, of The American College of Physicians -- speaker at the December 15th briefing cosponsored by The Commonwealth Fund. |
Gail Wilensky, senior fellow at Project HOPE -- speaker at the December 15th briefing cosponsored by The Commonwealth Fund. |
Stu Guterman, of The Commonwealth Fund -- moderator at the December 15th briefing. |
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