"ACP's framework aims to ensure that measures are evidence-based, consistent across health plans, developed by the medical profession and validated through a consensus process," said C. Anderson Hedberg, MD, FACP, president of the American College of Physicians. "Data collection must be accurate and administratively feasible, and the analysis and reporting of physician performance must be based on valid and reliable assessments across populations. Financial incentives must be adequate and equitable and savings realized by improvements in care must be proportionally shared with those responsible for producing the savings. Finally, it is critical that quality--not just cost reduction--always be the overriding measure of success."
The paper notes that ACP's support for P4P requires a comprehensive re-examination and restructuring of Medicare payment policies to support quality improvement, particularly for patients with multiple chronic diseases. P4P can work, ACP contends, only if Congress takes into account the diversity of clinical practices across the country --particularly the challenges faced by smaller practices--and moves to replace the sustainable growth rate formula (SGR) with new methods of reimbursement that reward those who follow evidence-based standards of care.
The results of a 12-community study on physician responses to P4P, recently released by The Center for Studying Health System Change, reinforce ACP's recommendations that sufficient dollars be allocated to P4P, that consistent and feasible measures be used across P4P plans and that P4P programs be designed in such a way that supports small practices rather than accelerating the quality gap between small and large groups.
"ACP is confident that physician adoption of quality improvement strategies upon which incentives are based, if done right, can result in better outcomes, increased physician and patient satisfaction, lower costs, and overall higher quality care," Dr. Hedberg concluded.
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 119,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection and treatment of illness in adults.