|Selected research from leading health care experts whose findings have a direct bearing on public policies effecting medical progress. Research is chosen based on its quality and relevance by the Medical Progress Today editorial staff.||
Care Patterns in Medicare and Their Implications for Pay for Performance
Researchers in the New England Journal of Medicine warn that health gains from payforperformance incentives will be limited because our fragmented health care system makes it difficult to measure the respective contributions of the several different physicians who may find themselves caring for a single patient.
We analyzed Medicare claims from 2000 through 2002 for 1.79 million feeforservice beneficiaries treated by 8604 respondents to the Community Tracking Study Physician Survey in 2000 and 2001. In separate analyses, we assigned each patient to the physician or primary care physician with whom the patient had had the most visits. We determined the number of physicians and practices seen annually, the percentage of care received from the assigned physician or practice, the stability of assignments over time, and the percentage of physicians' Medicare patients who were their assigned patients.
The researchers concluded that
In feeforservice Medicare, the dispersion of patients' care among multiple physicians will limit the effectiveness of payforperformance initiatives that rely on a single retrospective method of assigning responsibility for patient care.
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