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Journal of General Internal Medicine

, Volume 24, Issue 7, pp 854–859

First Online: 18 March 2009Received: 26 July 2008Revised: 23 December 2008Accepted: 26 January 2009 ABSTRACT

BACKGROUNDPay-for-performance is proliferating, yet its impact on key stakeholders remains uncertain.

OBJECTIVEThe Society of General Internal Medicine systematically evaluated ethical issues raised by performance-based physician compensation.

RESULTSWe conclude that current arrangements are based on fundamentally acceptable ethical principles, but are guided by an incomplete understanding of health-care quality. Furthermore, their implementation without evidence of safety and efficacy is ethically precarious because of potential risks to stakeholders, especially vulnerable patients.

CONCLUSIONWe propose four major strategies to transition from risky pay-for-performance systems to ethical performance-based physician compensation and high quality care. These include implementing safeguards within current pay-for-performance systems, reaching consensus regarding the obligations of key stakeholders in improving health-care quality, developing valid and comprehensive measures of health-care quality, and utilizing a cautious evaluative approach in creating the next generation of compensation systems that reward genuine quality.

KEY WORDSethics health policy pay-for-performance quality improvement physician reimbursement  Download fulltext PDF

Autor: J. Frank Wharam - Michael K. Paasche-Orlow - Neil J. Farber - Christine Sinsky - Lisa Rucker - Kimberly J. Rask - M. Ka

Fuente: https://link.springer.com/

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