ASCRS general session examines debate over P4P

Four representatives of government and academia weighed in on the pay-for-performance (P4P) issue during the government relations general session of the American Society of Cataract and Refractive Surgery (ASCRS) symposium.

In her welcome, Priscilla P. Arnold, MD, chairman, ASCRS Government Relations Committee, likened the gathering elements of P4P to "a perfect storm." Dr. Arnold then posed questions to the audience on the potential impact of P4P on medical practices, and concluded by detailing efforts of ASCRS management to deal with P4P.

Presenters for the session were Roy Ramthun, special assistant to the president for economic policy-health; David Brailer, MD, national coordinator for health information technology; Herb Kuhn, director, Center for Medicare Management, Centers for Medicare and Medicaid Services; and James C. Robinson, PhD, MPH, professor of health economics and chairman, Division of Health Policy and Management, University of California, Berkeley.

"Since Medicare is the single largest purchaser of health care in this country, we frequently focus on Medicare as a place where some of the policy tools might actually play out," said Ramthun. He continued by saying that projections are that the U.S. will spend $390 billion on Medicare in 2007. That figure is expected to reach $2.2 trillion in the next 5 years.

"Should we reward the level of quality of performance or the level of change of improvement in the level of quality? The argument in favor of rewarding quality is P4P should be P4P. You have high performance, you make more money. You have low performance, you make less money," said Dr. Robinson.