Pay for performance and health-care reform

The rumble that we hear is the health-care reform train fast approaching. Scrutiny of current trends and experimental projects indicates that payment methodologies in the future will be based at least in part on quality of performance by providers, with performance defined not only along the lines of clinical parameters and outcomes, but also by efficient utilization of resources. Essential elements for the success of these programs include identification of relevant and valid performance measures, correct data capture and attribution, appropriate benchmarking, and timely and accurate feedback to providers.