This thread on "venting" has taken various twists and turns; maybe it should just continue forever as an open invitation to... well, vent.
Pay for performance is here to stay, and I don't think we can stop it. Actually, I don't think we should try. What is essential though is to fight inappropriate implementation. The example Steve brings up is a perfect one. I would suggest a well-thought out (if ultimately, "templated") letter along these lines:
"I am in full agreement with your goal of providing superior diabetic care to your premium members, and I also agree with your stated plans to compensate me at a higher rate for providing such care (though I have not yet received such payments). Please note from the attached print out that 95% of my diabetic patients had an A1C, blood pressure control, lipid testing, diabetic foot care, and microalbumin/creat ratio done. Also note that I ordered diabetic eye exam on all. Please note that I have implemented an EMR at considerable time and expense which allows me to provide this precise documentation of my superior care to you.
Unfortunately, only 28% of the patients chose to get the eye exam which I recommended. How do you propose to improve this rate? Can you do something to make access to eye care easier and perhaps cheaper for my patients so that they will be more likely to follow my recommendations?"
