Rachel Werner, Marketplace Radio Show, Pay for Performance

Rachel Werner, Marketplace Radio Show, Pay for Performance

LDI Senior Fellow Rachel Werner was featured in an American Public Media Marketplace radio show marking this month's one year anniversary of the launch of the Affordable Care Act and its healthcare.gov website.

Werner, MD, PhD, an Associate Professor of Medicine at Penn's Perelman School of Medicine and Core Investigator with the VA Health Services Research and Development Center for Health Equity Research and Promotion (CHERP), was one of several national
Rachel Werner
Rachel Werner, MD, PhD

health policy experts weighing in on the show hosted by journalist Dan Gorenstein.

Payment reform
Gorenstein focused on the various payment reform strategies that could replace the current "fee-for-service" system that rewards physicians and hospitals for maximizing the quantity rather than the quality of the work they bill for.

Meredith Rosenthal, PhD, Associate Profess of Health Economics and Policy at Harvard told Gorenstein that "Evidence is very clear that if you pay for volume, you get volume and if you stop doing that, you get less."

Unnecessary care
Gorenstein pointed out that insurers were working to determine which payment method could curb unnecessary and sometimes harmful care and that "Pay for Performance" (P4P) was one that offers physicians financial incentives to meet certain quality benchmarks.

Peter Ubel, MD, Professor of Business Administration and Medicine at Duke's Sanford School of Public Policy, said "In theory it sounds so obvious that you should pay people more when they do their job better." He noted the current distorted financial incentives are enough to make a physician see pneumonia where pneumonia doesn't exist.

Additional research
Werner, who has been studying P4P systems, said the "We don't know exactly what doctors should be doing to provide high quality care at a low cost" and emphasized that what's needed most is more time to experiment with payment models to better understand what actually works.