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Pay for performance

The following articles have the tag Pay for performance

Nothing to fear: GP performance indicators will be ‘voluntary’

GPs have been assured that recent media speculation that development of new performance management indicators will lead to pay-for-performance funding for general practice is completely unsubstantiated.

UK expert backs pay-for-performance models

A LEADING UK healthcare expert has endorsed the Gillard Government’s decision to pilot its pay-for-performance (PFP) diabetes care scheme, saying the controversial funding model is a potentially important element in the future of primary care. Dr Stephen Campbell, senior research fellow at the University of Manchester’s National Primary Care Research and Development Centre, told MO that a similar scheme introduced in the UK had proven the concept could work. Even better results could have been achieved if the scheme had been piloted before implementation, he added.  Dr Campbell was due to deliver a public lecture on the ...

Setback for pay-for-performance scheme

THE Gillard Government’s hopes for a future pay-for-performance diabetes scheme have been dealt another blow, with a UK study suggesting the change would encourage GP “gaming” and worsen health disparities. A study of 4000 patients with diabetes registered with 23 London practices found that pay-for-performance – which is already fully operational in the UK – encouraged crowded or “more deprived” clinics to exclude older and longer-term patients from reporting benchmarks. Excluded patients were less likely to achieve treatment targets, according to the study authors, who warned that “permitting physicians to exclude patients from pay-per-performance programs may worsen ...

Setback for pay-for-performance scheme

THE Gillard Government’s hopes for a future pay-for-performance diabetes scheme have been dealt another blow, with a UK study suggesting the change would encourage GP “gaming” and worsen health disparities. A study of 4000 patients with diabetes registered with 23 London practices found that pay-for-performance – which is already fully operational in the UK – encouraged crowded or “more deprived” clinics to exclude older and longer-term patients from reporting benchmarks. Excluded patients were less likely to achieve treatment targets, according to the study authors, who warned that “permitting physicians to exclude patients from pay-per-performance programs may worsen ...

Pay-for-performance schemes lack IT support

PAY-FOR-PERFORMANCE schemes should not be viewed as a panacea for health system funding, experts warn, and health policy makers must give serious consideration to Australia’s health IT systems before starting on this path. Writing in this week’s MJA , researchers from the Australian National University and the University of Melbourne said Australia needed to take particular note of lessons learned from the failures of the Quality and Outcomes Framework (QOF) scheme used in the UK. Co-author Professor Anthony Scott, from Melbourne University’s Institute of Applied Economic and Social Research, said the UK pay-for-performance system had largely ...

Roxon defends diabetes scheme after survey backlash

HEALTH Minister Nicola Roxon has been forced to defend the Government’s controversial block funded diabetes management scheme, with GPs overwhelmingly rejecting the scheme according to a new poll. A national online survey of 487 GPs conducted by the AMA found that just 4% of respondents planned to adopt the blended block funding and pay-for-performance model for diabetes management set to come into force from 2012. Sixty-four per cent of GPs said they would not sign up to the voluntary model while 32% remained unsure about the benefits of the new system over existing fee-for-service arrangements. The ...

Western Australia steadfast on GST takeover resistance

AS the deadline for the Federal Government’s health reforms looms, Western Australia is remaining firm on its refusal to sign up to the controversial plan. With new health funding arrangements set to commence from 1 July, WA remains the only state not to have signed up to the agreement, which would see the Government assume control of 30% of the states’ GST revenue. The revenue would be placed in a pool of funding used to finance health and hospital services. The deal would provide funding for increased GP training numbers, additional money for aged care as well ...

Govt targets HbA1c as marker of success

THE Federal Health Department has given the clearest signal yet that HbA1c levels will used as a benchmark to monitor improvement of patient care and outcomes under its controversial new diabetes funding scheme. The news has led to renewed calls from diabetes and primary care experts for caution in using the measure. There is also ongoing concern that such an indicator would be clinically inappropriate and difficult to implement given the limitations of existing national data. Previous concerns about have also been raised over GPs’ inability to control patient behaviour. Responding to questioning during recent Senate ...

GPs push AMA to take hard line on health reforms

The AMA federal council will be scrutinising voluntary patient enrolment, fundholding and pay for performance after delegates at the association’s National Conference supported two urgent motions on Saturday. Introducing his motion on Friday, Queensland GP Dr Shaun Rudd called on the AMA to condemn “attempts to procure voluntary registration and wholesale doctor patient fund-holding as unwarranted bureaucracy and a hazard to quality care”.  “The most important thing to me is an autonomous doctor patient relationship,” he said. “It [voluntary patient enrolment] is the worst thing that could happen to general practice.” Dr Rudd took aim at ...

AMA alternative to diabetes scheme gets RACGP backing

THE AMA’s recently-released alternative to the Rudd Government’s unpopular diabetes plan has won over the RACGP but at least one senior academic is unconvinced of its merits.  The alternative model comes a month after the Government unveiled its $436 million diabetes scheme, which will introduce voluntary patient enrolment and pay for performance into general practice. Under the AMA model, existing GP Management Plans would be simplified, allowing patients to access five allied health visits and selected home aids, including safety and mobility equipment, without the need for additional Team Care Arrangements. For patients with chronic and ...

GP income threatened by new diabetes scheme

GPs will need to look closely at their practice contracts to ensure their personal earnings don’t take a hit under the Government’s new diabetes scheme. The $436 million scheme will see practices awarded block-funding for each patient they enrol, plus an average bonus payment of $10,800 per year based partly on their performance in keeping patients healthy. Block funding will consist of annual payments of $1200 per enrolled patient, which will be split $950 for general practices and $250 for allied care. It remains unclear, however, whether the $250 for ...

Government splashes more cash to entice GPs on diabetes scheme

Government splashes more cash to entice GPs on diabetes scheme

PRACTICES will be offered an additional $1500 enticement if they sign up  for the Government’s controversial new diabetes management scheme. The scheme will see GPs rewarded for meeting patient care targets. The sweetener payments were revealed by the Government last week following widespread GP criticism of the controversial new plan, which will see patients with diabetes voluntarily enrol with a practices that will take responsibility for their management. Participating practices will also receive further bonus payments for achieving targeted levels of patient outcomes. The Government had already promised practices would be paid $1200 per year for each enrolled ...

Pay for performance improves care

PAY-FOR-PERFORMANCE (P4P) programs are an effective way to encourage “low performing” physicians to lift the quality of their patient care, US researchers have claimed. In a four-year study that compared the work of physicians signed up to P4P to the work of those who were not, researchers noted that those in the programs were more likely to carry out the incentivised tasks. Low-performing physicians improved the most during the study, and were more likely to maintain these improvements, when compared to those not receiving incentives. Researchers examined seven preventive health and patient management tasks, including cervical ...

Rudd admits to hard times on health reform

THE Prime Minister has admitted his sweeping health reform agenda is nine months behind schedule, however he still insists he has time to “get it right”. Ahead of the 2007 election, Kevin Rudd promised he would bring the health system up to scratch by mid-2009, or begin moves to take over the funding of all of Australia’s public hospitals. However, at the weekend he told the ABC’s Insiders program that it was easier to talk the talk than walk the walk. “We’re now about nine months ...

GPs pull together to fight reform plans

GPs pull together to fight reform plans

AS GP frustrations at proposed healthcare reform boiled over in western Sydney this week, the AMA announced a new taskforce to protect GP interests. The association is currently drawing together a new GP Campaign Taskforce, to be charged with assessing and tackling the threats and impacts of proposed health reform in the lead-up to next year’s federal election. The taskforce emerged as doctors attending the recent day of action voted to establish their own body - Doctors Action - to step up the fight against government policies, involving the role of nurse practitioners and the establishment ...

Patient care improves under pay for performance

AUSTRALIAN GPs have nothing to fear from pay-for-performance models, a UK academic has claimed, as such systems can give rise to rapid improvements in the quality of patient care. Presenting a public lecture at the Australian National University, Dr Stephen Campbell (PhD), a senior research fellow at the University of Manchester, said the GP pay-for-performance model introduced in the UK had led to a drop in inequalities in patient care. Under the Quality and Outcomes Framework (QOF), practices receive financial rewards for reaching a set of government-set benchmarks around patient care and practice administration. The poorest ...

Government push for large clinics fragments care

THE Government’s push for larger health clinics, target-based incentives for GPs and dispersing care may be endangering patients with chronic comorbidities and overseas experts argue GPs must remain the central coordinators of care. Writing in the BMJ , British public health academics contend that these patients could be overburdened by their treatment, and rather than fragmenting care through target-based incentives and delegation of chronic disease surveillance to nurses or patients, the coordinating role of GPs should be preserved and enhanced. Australian experts have also weighed into the debate. Professor Mark Harris, executive director of the ...

Pay for performance might have its place

THOSE of us working in general practice feel we are generally doing a good job – we care about our patients, we put in extra hours to ensure the red tape is signed off, we do professional development training and stay on top of our game. But how do we really know we are hitting the mark? Measuring what we contribute to general practice is a difficult task and makes learning harder when continuous quality improvement is not embedded in our systems. Measurement may be harder for us than our specialist colleagues, who can measure outcomes ...

Debate over HbA1c target in pay for performance

EXPERTS have continued to question Federal Government proposals to introduce a pay-for-performance scheme for diabetes management in Australia, saying the appropriate HbA 1c target is being reconsidered internationally. However, Australian experts argue that if GPs were to be remunerated for diabetes management, using higher glycaemic targets would be preferable to a lower target such as the 7% HbA 1c level introduced as a payment benchmark in the UK. Two international diabetes experts said the recently introduced UK scheme rewarding GPs with a £3000 ($6200) payment for achieving HbA 1c levels below 7% in half ...

Safety fears over pay for performance

Safety fears over pay for performance

MAKING GP payments contingent on reaching specific clinical targets may result in poorer patient outcomes and even increased mortality risk, experts have warned. As the Federal Government considers introducing a pay-for-performance scheme in Australia, British experts have attacked their government’s performance-based diabetes management policy as lacking evidence and potentially harmful. Under the UK scheme, due to begin next month, GPs will be rewarded with a £3000 ($6640) payment if they lower HbA 1c levels to below 7% in half of their patients with type 2 diabetes. However, in a BMJ editorial, two British ...

Beware pay-for-performance traps

THE federal government should be cautious of adopting widespread pay-for-performance measures, a leading academic has warned, as international experience of such systems has revealed several pitfalls. Earlier this year, health minister Nicola Roxon suggested a model of financial incentives tied to patient outcomes, where states and territories could receive payments by encouraging people to quit smoking. However, according to Associate Professor Ian Scott, director of the Clinical Services Evaluation Unit at Brisbane’s Princess Alexandra Hospital, empirical evidence from the UK – where pay for performance allows GPs to boost their income by meeting up to 146 targets ...

Paying for performance

Paying GPs to meet healthcare benchmarks is the latest policy idea doing the rounds in Canberra. Elizabeth McIntosh sizes it up. GO to work. Do work. Get paid. Simple? Not if you’re a GP trying to negotiate the minefield of Practice Incentive Payments (PIPs), Medicare’s vagueness on Level C and D consults, and an ever-expanding MBS. Now add to the mix a new model that proposes to pay GPs for exceeding certain benchmarks and the general practice landscape suddenly begins to look even more complicated. Pay for performance (P4P) is the new ...