"Performance-based pay...is irrelevant to the complexities and professionalism of good doctoring and other human services like education."
https://www.statnews.com/2018/01/30/pay-for-performance-doctors-hospitals/ … via @statnews
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Key is 2 things you said: groups of clinicians and iteration. Both point to focusing on well-defined medical conditions first, and then expanding towards capitation. Much harder to iterate on an ACO than on a bundle. Physician-led ACOs/Medical Homes picking bundles is promising.
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Hospital-led ACOs are too complicated an entity and about as useful as Pharma-led ACOs. Doctors within them are inadequately empowered to deliver the improvement we want; the larger the team, the more the free-riding and lack of responsibility.
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Is the hospital led vs physician led difference that firmly established? Can you point me to the best research?
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I was sharing my intuition on physician-led ACOs—
@Farzad_MD is the man on this -
Great. Thanks-was afraid I had missed something and would need to reevaluate some of my research
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Agree. Better-designed care systems are the best way forward. This means bringing in new disciplines, re-engaging clinicians, & trusting managers closer to clinical front lines to make decisions
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It also means removing bad incentives, for reasons I hope are obvious. One place to start:https://twitter.com/drkatejmiller/status/954485122606100480 …
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