Pay for increasing knowledge and you'll get better performance

LETTER — Posted April 11, 2005

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Regarding "AMA: Medicare pay-for-performance must be voluntary and not punitive" (Article, March 21): I respect and appreciate the efforts of the AMA to set forth worthy principles and standards in their Guidelines for Pay-for-Performance Programs. But I think the frog has leaped before it came into view.

Performance reflects knowledge, and the only way to derive data on performance is through education and its application to patient care. Education should be the first measure for payment enhancement, and implementation of practical learning into clinical practice should have measurable outcome opportunities.

There is a thirst for continuing educational and professional development, but the priority is often income-producing patient care. Creating a method in which educational effort can be rewarded will provide balance and has the best opportunity to improve care and outcomes. It will give specialty organizations the chance to become involved through the development of CME programs that are endorsed by payers and their pay-for-performance programs.

Demonstration of competency in various specialty-specific educational programs should be the first measure of enhanced value and will create the chance to evaluate the effectiveness of clinical advances to improve care and better use health care funds.

Russell C. Libby, MD, Fairfax, Va.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/04/11/edlt0411.htm.

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