P4P in the UK

General Practitioners (GPs) in the UK NHS are paid a mixture of capitation, lump sum allowances, and a pay-for-performance bonus. The P4P element, the Quality and Outcomes Framework (QOF), rewards GPs according to their performance on a large number of indicators. QOF payments represented up to 20% of GPs ’ income in the first year…

Are ACOs working?

Maybe. An press release from CMS is very upbeat on ACOs. What do the numbers say? Farzad Mostashari and Ross White review the CMS report and find that results were mixed: Of the 114 ACOs in the program, 54 of the ACOs saved money and 29 saved enough money to receive bonus payments. The 54…

Extended Cost Effectiveness Analysis

Most people know what cost-effectiveness analysis (CEA), but what is extended cost effectiveness analysis (ECEA)?  A paper by Verguet, Laxminarayan,and Jamison (2014) describes the ECEA approach as it relates to the benefits of universal public finance (UPF) of specific medical treatments.  CEA measures the effectiveness of a treatment relative to its cost.  ECEA does this…

Are we running out of antibiotics?

Nicole Allan of the Atlantic discusses why overuse of antibiotics is making them less effective.  The fact that antibiotics are less effective did not come as a surprise to many experts.  In fact, in 1945, “while accepting a Nobel Prize for discovering penicillin, Alexander Fleming warned of a future in which antibiotics had been used…