Pay for Performance A Mechanism for Quality Improvement

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Roli Dwivedi MD
Carrie Link MD
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P4P, ACCORD
Purpose Determine resident and faculty
understanding of P4P, ACCORD Method 13
question survey via Survey Monkey
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Survey Participants

• N 66
• 60 residents
• 40 faculty

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Survey

• 13 questions
• Some repeated questions from prior 2 years

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Defining P4P

• 8 respondents No idea

• 58 respondents 78

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Defining P4P

• A simple answer
• Financial reward for achieving markers of quality
• A sophisticated answer
• Full or bonus reimbursement based on performance
  in patient care. Need to attain preset goals for
  care of a given diagnosis in proscribed
  percentage of patients.

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Emotionally charged
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How well do you know P4P guidelines?
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Clinic efficiency With P4P
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Clinic Outcomes With P4P
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How well do you know ACCORD?
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Describe ACCORD-No Idea-

• 32 of respondents
• 49 of residents

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If P4P guideline increased MM
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Change opinion about P4P
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Summary

• Clinic efficiency is neutral
• Clinic outcomes are positive
• Use guidelines with exceptions
• P4P takes a hit when the evidence changes

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?
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Survey Trends
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So where do you stand??