UnitedHealth forces pay-for-performan...

UnitedHealth forces pay-for-performance measures in new contract

There are 8 comments on the Chicago Tribune story from Nov 28, 2007, titled UnitedHealth forces pay-for-performance measures in new contract. In it, Chicago Tribune reports that:

An end to a rift that began almost four years ago between Advocate Health Care and managed-care giant UnitedHealth Group over payment rates will result in new pay-for-performance measures for Advocate doctors ...

Join the discussion below, or Read more at Chicago Tribune.

rjnchi

Elk Grove Village, IL

#1 Nov 28, 2007
in other words.....your doc will get paid more $$$ if he keeps costs down on treating you - i.e., not spend more on your care than the ins co. wants him or her to.
TCMD

Las Vegas, NV

#2 Nov 28, 2007
So what I do as a physician is get rid of all my noncompliant patients who don't take their medications and keep only the best and healthy ones so that I can meet their pay for performance standard. Will United Healthcare allow this or will they put the blame on the physician for the patient not taking their asthma or diabetes medications.
EYG

Rowlett, TX

#4 Nov 29, 2007
This is exactly why doctors have been fighting this trend. First the insurance companies tried to assure "everyone" that they wouldn't use cost as a measure of quality. Now, as predicted, that's exactly what they are doing. It is bad medicine to equate saving money with quality care. And yes, the physician always gets blamed. The insurance behemoth can do anything it wants.
mitch

Menomonee Falls, WI

#5 Nov 30, 2007
sounds good until someone doesn't get referred to the ER because the Doc wants a bonus--way to set up ethical conflict instead of paying for treatment!
Az Ins dude

Scottsdale, AZ

#6 Nov 30, 2007
UHC ROCKS! Finally an insurer carrier that puts providers in their place! I'm tired of dr.'s not taking the time to do what they went to school for 8+ years. TO TREAT PATIENTS! You see Dr.'s not taking the time to "explain" & "properly" diagnois you because they are to busy running their practice's like a fast food joint. In & out!
This will force providers to take the time to treat you & so providers will finally earn their overpriced high dollar fees! By the way, mitch, UHC plans are all open access, you don't need any referals! You can self refer to any specialist & self refer to any ER!! thx
exposem

Hartford, CT

#7 Dec 1, 2007
Ancient Chinese used to withold $$$ from doctors till they were cured.
Akron Oh

Cuyahoga Falls, OH

#8 Dec 3, 2007
Pay for performance can be a good thing. I hope the insurance companies will share this information with their members. Yes, good doctors should make more money. What is wrong with that? If a doctor has good outcomes after surgery and the patient gets better, why not give him more money. If the doctor has lots of patients getting flu shots, mammograms and pediatric immunizations, he should get more money. There are lots of areas that can be included in this study that don't involve reducing needed healthcare.
Health Care Diva

Searcy, AR

#9 Dec 5, 2007
Just like anything else with the health care system, there are conflicting interests. With conflicting interests and competing agendas, there are opportunities for abuse and bullying. The one thing that I do not like is that it has been said that certain Insurance Companies are notorious for denying claims and not paying their providers the way they should. These insurance companies may abuse P4P reimbursement. Still, transparency is a very good thing in health care in the age of consumerism. Yet, even in a transparent system, things go on behind the scenes that are not so exceptional. What needs to be remembered with the whole argument of compliant and non-compliant patients and sickly groups and well groups is that the measure should reflect the care rendered accross the entire spectrum of patients. This should show overall whether a doctor or provider is high quality or not. Individuals and their behaviors should make little impact on the larger care population. If you are in a situation where you are dealing with regional variations, this can be botched, however. Basically, there are pros and cons. What we need to remember is that sometimes what looks so great on paper does not work out so great in reality. The big question will be, Does the patient come first? as a result of P4P reimbursement?

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