Pay-for-performance schemes financially reward MDs for hitting special numerical targets such as hospital stay, readmissions, use of certain drugs, and cost controls. An article in the August issue of the British Medical Journal take the position that pay-for-performance will do more harm than good by changing the mindset of the physician. The Accountable Care Organization, as part of the Affordable Care Act, as will HMO insurance companies, is moving in the direction of this approach.
When you challenge MDs to choose between achieving certain numerical targets to achieve a better income vs just quality of care, there is an inherent conflict of interest that they must resolve.
