Good is Never Enough for P4P

P$P programs, like CMS Core Measures, while a valuable goal, are primarily about documentation. Documenting the proper activities occurred, within the accepted timeframes is what Core Measures is all about. Did you give the AMI patient aspirin soon enough to be effective, did the pneumonia patient get the correct medication early enough?

Although administrative and nursing/allied medical staff can and will respond to the Quality challenges, physicians (forgive my stereotyping) must be approached more comprehensively to elicit medical behavioral change based on evidenced based medicine or process improvement.  They will slow the process if not attended to their resistance factors for change.  Hospitals and medical groups...

The Premier (Hospital Purchasing Alliance) and Center for Medicare and Medicaid Services (CMS in the U.S. Dept. of HHS) have undertaken the nation's highest profile pay for performance program for about five years now.  Those 250 plus hospitals participating are finding that the longer they do the more difficult it is and will be for them to rank sufficiently high to receive bonus payments...