Dollars for Quality Doc’s

It might sound like an insignificant bit of administrative trivia from the healthcare world, but after what sounds like was some serious wrangling between Medicare administrators, private health insurance, consumer groups and employers, they have agreed on a way to rate, and pay for, doctor’s performance.

Big yawn you may think.

But this is a significant step in the revolution that is taking place, moving away from fee-for-service payments - where the more appointments, tests, procedures your doctor does, the more money he or she makes – and is therefor incentivized to do more rather than less (“medicine by the yard” as the wags refer to it).

Could it be that healthcare in the US costing twice as much as equivalent countries, and being a doctor is a coveted job here in the “home of the brave and the land of the free” has something to do with this?


What this cheapskate coalition is advancing instead is the trend toward “pay-for-performance” (“P4P” if you want to be smartarse about it).


The outrageous idea of doctors getting paid for keeping you well – measured by such demographics as control of blood pressure; avoidance of re-admission for heart failure; control of HIV; management of different kinds of cancer. Rather than just how much they do.


There’s nothing like money of course to get people incentivized. But the spin off for the medically emancipated patient is that this information about quality of care will be made public, allowing you to know who is a good, effective doctor.

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