New ways to measure the doctor's good deeds, and remunerate her or him in a better way ....

This article represents a big shift, at NYC's municipal level, from the easy-quantification way of paying  medical doctors in hospitals, to a system that is evaluative of the work of each doctorto determine how much financial reward he or she shoud get.  I see room for new forms of abuse in this paradigm, but I favour it because the old way was a shambles in inequity and iniquity.  What's more, "the new law could change longstanding relationships, giving more power to some of the poorest and most vulnerable patients over doctors who run their care."  I wrote about this from personal experience in the early days of this blog:  my six-part series near the launch of this blog, and which I can't find at the moment.  There doesn't seem to be an archive of back posts.  In any case, please read this NYT article by Anemona Hartocollis, as it may portend the future of medical remuneration of doctor's and nurses everywhere.

— Albert Gedraitis


New York City:  
Doctor's will get paid more for good care, less for lousy care

by ANEMONA HARTOCOLLIS

Published: January 11, 2013

In a bold experiment in performance pay, complaints from patients at New York City’s public hospitals and other measures of their care — like how long before they are discharged and how they fare afterward — will be reflected in doctors’ paychecks under a plan being negotiated by the physicians and their hospitals.

The proposal represents a broad national push away from the traditional model of rewarding doctors for the volume of services they order, a system that has been criticized for promoting unnecessary treatment. In the wake of changes laid out in the Affordable Care Act, public and private hospitals are already preparing to have their income tied partly to patient outcomes and cost containment, but the city’s plan extends that financial incentive to the front line, the doctors directly responsible for treatment. It also shows how the new law could change longstanding relationships, giving more power to some of the poorest and most vulnerable patients over doctors who run their care.

“I would expect that we’re going to see this become more and more prevalent in compensation arrangements,” said Alan Aviles, president of the city’s Health and Hospitals Corporation, which runs the city’s 11 public hospitals and is the country’s largest public health system, handling more than 1 million emergency room visits a year.

The corporation’s plan would make doctors’ raises dependent on their performance on quality measures. The details are being negotiated with the doctors’ union, but both sides expect to reach an agreement that incorporates the idea.

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