Transformation of Health Care at the Front Line

Concern about escalating costs and the quality of health care delivered in the United States continues to mount.¹ This has led to an increasing focus on pay-for-performance, value-driven health care and public reporting of quality and cost information. However, several authors have questioned the effectiveness of pay for performance and public reporting to improve patients' outcomes and have highlighted the potential for unintended negative consequences.^2-6 Currently, frontline clinicians are exposed to disparate pay-for-performance programs that are often uncoordinated and not clearly aligned with producing better outcomes for patients.^{2, 6} Evidence is produced at an astonishing rate, but its incorporation into clinical practice is difficult.

For patients, the current transparency efforts often have little useful information for decisions regarding a specific disease and selection of clinician or treatment option.⁷ However, policy makers and purchasers are faced with an underperforming health care system and untenable . . . [Full Text of this Article]