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Pay-for-Performance Contracts in Diabetes Care

The first 300 words of the full text of this article appear below.

	Introduction

 
There is a growing sentiment to tie physician performance in the care of certain key disorders to insurance reimbursement.¹ Diabetes is one of those disease states. This concept is not only being advocated for Medicare beneficiaries, but also is being considered for many private health insurance contracts.² Because private insurers are encouraged to offer Medicare beneficiaries alternative insurance plans,¹ there is no reason to believe that so-called "pay-for-performance" plans will not be included in the insurance contracts for these Medicare alternatives. If pay for performance becomes a widespread concept in health insurance, there is no doubt that it will be applied to diabetic patients. Therefore, it is important for providers in diabetes care to understand this concept and its practical implications to their work.

	Design of Pay for Performance

 
The concept of pay for performance has gained much momentum in the past few years. There is the intention of applying this scheme to all levels of health care provision, ranging from individual providers to hospitals and nursing homes.¹ There is much enthusiasm about how the application of this form of reimbursement will improve the health status of the American population,^3-5 and many recognized experts, both health professionals and lay experts, are enthusiastic about this model.

Pay for performance depends on the basic assumption that specific and reliable end points of care may be identified that will measure whether the care rendered to patients is carried out in a reasonably competent manner.^1,6 Demonstration projects are in progress.⁶ Advocates of pay for performance describe end points that would be taken from the official guidelines of national health organizations such as the American Diabetes Association (ADA).⁷ The idea is that the systematic application of such guidelines can significantly improve diabetes care.⁸ Pay-for-performance contracts would financially reward providers when their patients' care meets the applicable guidelines and decrease . . . [Full Text of this Article]

	Application of Pay for Performance to Diabetes Care

 

	Problems With Pay for Performance in Diabetes Care

 

	Possible Outcomes of Pay for Performance

 

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