Harvard-based researchers surveying early adopters of P4P and comparing their payment reward systems between 2003 and 2006 found that performance measures used to evaluate and reward physicians and hospitals have shifted from a focus on processes to patient outcomes, cost efficiency and use of information technology.
The study found increasing numbers of P4P plans using cost efficiency measures as a target for rewarding physicians and hospitals. In 2003, sponsors representing 60 percent of enrollees included cost efficiency measures as a prominent aspect of their P4P schemes. By 2006, sponsors representing 92 percent of enrollees were using cost of care to measure a physician's performance score. The analysis also showed that the majority of programs have augmented the money available for performance-based pay.
Additionally, according to the study, the inclusion of specialists in P4P increased between 2003 and 2006
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