Shift Happens. Not

The article in the Wall Street Journal was called Medical Shift Fails to Cut Hospital Infections and once again it should be the smoking gun telling us not to turn to P4P/Quality Indicators.   For those who can’t read the article, here is a snippet:

A high-profile Medicare policy that sought to reduce certain hospital-acquired infections by cutting payments tied to treating them turned out to have no impact, according to a new study in the New England Journal of Medicine.

The study, which looked at the effect of the 2008 payment change on bloodstream and urinary-tract infections related to catheters, found “no evidence” that the shift had any measurable impact on the infections, which were already decreasing before the change went into effect. The study follows other research that has cast doubt on the effectiveness of some efforts to tie reimbursement to quality-improvement efforts in health care, an approach that is being considerably ramped up under the federal health overhaul.

Okay, people, this is not a Democrat or Republican issue.  This is not a liberal or conservative issue.  This is about evidence.  Pay-for-performance does NOT have the evidence to back it up.   And yet we physicians let others bull rush us with this crap and tie our pay to it.  Why?  I have been blogging about all the non-evidence for years and yet the AMA and the AAFP continue to buy into this farce.  Why?   Because we want to help patients and not seem like we are standing in the way. The funny thing, though, is now we will be hurting patients.  The only reason that Medicare and the managed care wants to move in this direction is because they see light at the end of the tunnel.  Better patient care? No.  What they see is a way to pay doctors less and have TOTAL control on how we treat our patients.   Everyone loses except them.

23570cookie-checkShift Happens. Not