Sydney (Medpundit) is very smart. Much of what she believes is wrong (i.e. I disagree with her), but she’s a great indicator of where the conservative (in both senses of the word) solo doc is, and you can bet your sweet ass that her and her ilk are not happy about the move towards pay for performance. Where she’s sharper than the rest of the tools in her shed is that she realizes that the WaPo series on Medicare is softerning up the local audience (in the Congress) for greater use of P4P in Medicare–a train that is fast leaving the station (and one that I am in general on board).
She doesn’t like it. Go read her piece and assume that this will be the AMA response, cos it will be and more so when there’s real money on the line. And then we’ll see who really controls Medicare payment policy in this country.
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Depending upon how such a plan is stratified, it may mean little difference. The bottom line should be to pay enough that a doctor, hospital, pharmacy, etc can make a decent margin.
One dimensional approaches to a multi-dimensional problem provide benefit.
What about tort reform, the mad requests of JCAHO, and the climbing costs of living and insurance relative to the payment? Why don’t we ask those that regulate us to show that this regulation has improved the quality and availability of healthcare. I know of no such evidence.