Jon,
I agree wholeheartedly that Pay for Performance is here to stay, but I can't disagree more with you that we should do everything in our power to stop it--I have been crafting a letter to our two senators, one is Senator Baucus who has been very involved with the Affordable Care Act. But the point you make about shifting the responsibility onto the physician is the clever way to decrease cost and penalize us for the noncompliant patient. In this Brave New World, my office is now termed the reporting station, and the patient doctor relationship is now null and void. We are now instruments of the state somehow magically able to control our patients so all of the quality metrics are fulfilled, and if not the physician is financially penalized, and thus health care costs are reduced. By implementing an EMR to improve efficiencies in the office (oops, I meant to say reporting station) we are handing a butcher knife to the state to trim all the unnecessary fat from the present health care inefficiencies, and thus health care costs are reduced and care is magically improved.
If 28% of your patients do not get their eye exam your performance is subpar and you will not get your performance incentive payment, and you multiply that factor by a few thousand and health care costs will be significantly reduced at the physicians expense, and will occur more likely to the physician who is willing to be innovative and adopt an EMR and acheive all the stages of meaningful use.
Now, maybe I am still quite upset about my 1% penalty for not eprescribing by June 30th of last year, but it woke me up to reality--this is no longer theory, old jimmie boy and his family may not get to vacation this year.
Hopefully I can get my check for stage 1--I am still in the process of doing this and way behind the curve as you guys have been at this a lot longer than me.
Alright I have exposed my flank--let me have it, I am extremely shy by nature and verbal dexterity, as you can see, is not my strong suit, but I am trying to see some advantages to the future of medicine with the Affordable Care Act, but just having difficulty. jimmie
