Pay for Performance Can Drive Physician Behavior, but don't Forget the Patient

Implications: Using appropriate Pay for Performance programs can drive physician behavior and results in changes in utilization, these should be continued but the patient component is a larger issue.    

Analysis: Pay for Performance is one of the buzzwords going around in health care today as a way to improve clinical practice as per guidelines, improve patient outcomes and potentially reduce costs. As this article points out it can be effective in changing behavior and moving a physician to practice closer to the National Guidelines. 

While this article points out the apparent success of this program in moving provider behavior.  The bigger issue is moving patient behavior.  In many cases the provider may be doing all of the right things yet the patient is not adherent, i.e. does not fill the prescription, does not get to the lab to get the test, takes the medications inappropriately, etc.  Patient issues are the larger drivers of the problems with our health care system and maximizing our results.

We should continue to push programs that improve practice behavior, but must also recognize that the far greater issue is the patient.