Jul 23 2013
The Washington Post investigates how the use of data plays into what some view as a distortion in physician pay.
The Washington Post: How A Secretive Panel Uses Data That Distorts Doctors' Pay
Twelve colonoscopies and four other procedures was a typical day for [physician Harinath Sheela], according to Florida records for 2012. If the American Medical Association's assumptions about procedure times are correct, that much work would take about 26 hours. [Physician Harinath] Sheela's typical day was nine or 10. "I have experience," the Yale-trained, Orlando-based doctor said. "I'm not that slow; I'm not fast. I'm thorough." This seemingly miraculous proficiency, which yields good pay for doctors who perform colonoscopies, reveals one of the fundamental flaws in the pricing of U.S. health care, a Washington Post investigation has found (Whoriskey and Keating, 7/20).
Meanwhile, Medicare plans to accelerate the link between payment and quality -
Kaiser Health News: Medicare Announces Plans To Accelerate Linking Doctor Pay To Quality
Medicare had already decided that large physician groups -- those with 100 or more doctors, nurses, social workers or other health professionals -- will gain or lose as much as 1 percent of their pay starting in 2015. Those incentives would double to 2 percent the following year under draft regulations Medicare released this month. The proposal also would phase mid-sized physicians groups - those with between 10 and 99 health professionals - into the program in 2016 instead of in 2017. While they would be eligible for bonuses up to 2 percent, they would be shielded from any penalties for that first year (Rau, 7/22).
Also in the news, a study finds financial incentives for medical trainees leads to a jump in end-of-life discussions -
Reuters: Incentives May Encourage End-Of-Life Discussions
Offering medical trainees a financial incentive to write hospital patients' end-of-life wishes in their medical records led to a spike in the proportion of records with such notations, a new study found. Past studies have suggested that although many elderly people prefer to die at home instead of in the hospital receiving aggressive treatment, some never have a discussion about end-of-life care with their doctors or have such wishes recorded (Pittman, 7/19).
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 This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.
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Medicare's three-day rule: Longer hospital stays, no patient benefit