5 Health Care Myths

Bob Laszewski has a great posts on 5 false  “solutions” to reduce health care costs.  These are: EMR: Making electronic medical records universal will greatly improve health care quality, but the impact on cost will be minor.  Better quality care can reduce iatrogenic injuries and reduce cost, but the cost reduction–if any–will likely be small…

Does P4P improve quality?

Pay-for-performance (P4P) is the latest rage among health wonks as to how to improve the health care system. But does P4P really improve quality? Mullen, Frank and Rosenthal (2008) hope to answer this question. One would initially believe that paying physicians to perform certain medically necessary tasks will improve quality. Further, some P4P involves structural…

P4P: Be careful what you measure

Simon Caulkin, management editor of The Guardian, has a great article titled “The rule is simple: be careful what you measure.”  The article discusses the fact that measuring performance leads to better performance on the dimensions measured, but can often lead to significantly worse performance on the unmeasured dimensions.  For instance, What happens when bad…

Commentary on P4P

I recently read a Health Affairs article analyzing a pay-for-performance (P4P) demonstration. The Local Initiative Rewarding Results (LIRR) demonstration in California involved seven Medicaid-focused health plans in California between 2003 and 2005. Here are some of my most recent thoughts on P4P: The article seemed to show that P4P worked best when there was much…

EconLog on P4P

Arnold Kling of the EconLog site has some commentary on P4P when discussing Tim Hartford’s latest book (“The Logic of Life“). I have a very different approach to compensation. I think that the key is to change compensation schemes frequently. The reason is that any scheme can be gamed, and the longer you wait to…