Pay For Performance Essay

The analogy of paying an apple picker based on production compared to the challenge of paying a federal judge based on the quality of the justice he delivers is a potent one to lay the framework for the complexities of the US health system. More specifically, it highlights the challenge of shifting the payment mechanism in the US health system away from paying for volume to paying for quality. Some of the challenges in navigating this transition to paying for quality can be readily observed in the trenches of the health care delivery system level. Further examination of the issue also brings to light a broader matter, which faces virtually every aspect of the US healthcare markets and that is, the lack of homogeneity, from the level of severity of disease to the variation in how healthcare is delivered, which presents significant stumbling blocks in the advancement of meaningful change.
Challenge 1: Pay for performance
As discussed in the opening paragraph, one issue as a result of paying doctors based on fees is that there is no element of quality factored into the payments. The notion of too much quantity and too little quality provides some of the impetus in shifting how physicians are paid to a pay for performance system. Golden and Sloan define pay for
For this reason, the idea that incentives should be compatible with these professional values resonated with me and the challenges in formulating a system that compensates for these professional values. In many of the classes we have taken throughout this course, we have discussed the impact of physician training on healthcare in the US and the impact that variations in this medical education can have on how a medical doctor