P4P Won’t Work This Way Here

Wednesday, November 29th 2006
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Unlike many physicians (or future physicians) I’m not going out of my head trying to oppose pay-for-performance. This is even after I personaly heard HHS Secretary Leavitt admit that the only reason pay for performance was coming was to reduce physician reimbursement and control costs. I posted on that previously. Now, that may sound like a “no, duh” statement but it is one thing to know it, and another entirely to get it straight from the horse’s mouth.

My reasons, unsorted but mentioned throughout the blog, are for another posts.

I bring it up only so I can point out, that I think after hearing the Secretary speak we can dispense with any notion that P4P will work like this in the United States.

GPs earned an average £106,000 during the first year of their new contract, figures show.

Figures from the Information Centre for health and social care show average earnings rose by 30% during 2004-05.

Ministers and NHS bosses expressed concern that so much of the new money had apparently gone on pay, rather than on investment in services.

The new contract, which ushered in radical changes to the delivery of primary care services, was designed to give general practices additional funds to invest in improving and developing services to patients.

It included incentives to reward GPs and their practice teams for driving up the quality of patient care.

A large proportion of GPs’ earnings are now linked to the quality of care they provide, with payments made for the provision of extra services, such as contraception, child health and chronic disease clinics.

Basically the NHS’ pay for performance protocol, which I’ve commented on previously, has led to an increase in PCP earnings. One of my pet issues has been a desire to close the reimbursement, and thus the recruitment, gap between specialties and primary care. Apparently such a gap exists in the UK as well,

He said: “Prior to the introduction of the new contract, there were serious recruitment problems and GPs pay had fallen behind.

“This was officially recognised during negotiations and is reflected in pay increases under the new contract.

H/T Kevin, MD

p.s.

This really is my last post. I must go back to studying.