P4P and inequality

Pay-for-performance (P4P) is supposed to improve the health care quality for all. One may not be surprised if it were the case that more affluent, more educated individuals benefit most from P4P and thus existing health care disparities may increase. Author Lawrence Casalino and Arthur Elster, however, posit that P4P may actually reduce the quality…

Quality by any other name

Pay-for-performance or health care quality report cards are the latest fad in medicine. Different types of report cards, however, measure different things. Eve Kerr and co-authors investigate (‘Quality by any other name?’) how different quality measures compare against each other. The authors look at 3 types of physician review: Implicit Review: This involves using ‘subjective’…

Hospital Innovators 2007

Which hospitals are the innovators of 2007?  Joe Paduda points us to to the Fierce Healthcare website which lists the top 10 hopsital innovators of 2007.  Two of the top ten include St. Joseph’s Hospital in West Bend, WI and Cedars-Sinai Medical Center in Los Angeles.  Mr. Paduda is not overly impressed by the innovation…

Problems with Quality Measures

Are quality based incentive programs the solution for improving physician quality without increasing cost? While I believe that measuring quality is an important avenue by which quality can be improved, it is not a magic bullet. A study by Gilmore, et al. (HSR 2007) looks at a pay-for-performance scheme developed in Hawaii. The authors look…

Health Plan Report Cards

The National Committee for Quality Assurance (NCQA) is a “not-for-profit organization dedicated to improving health care quality.” One of their major initiatives is the Health Plan Employer Data and Information Set (HEDIS) which aims to evaluate the quality of care offered by various health plans. In a 2001 NBER working paper (“Learning…“), researchers Michael Chernew,…

Family MDs and Technology

Last month’s Wall Street Journal (“Faltering Family MDs get Technology Lifeline“) has an interesting article about how small-practice physicians are using technology as a weapon against the economies of scale which physicians working for large-scale practices enjoy. The article tells the story of Dr. Gordon Moore. When he worked at a large, hospital-owned medical practice,…