Adam I may have been misleading if I didn't make it clear that I am TOTALLY in agreement that P4P= less pay. NO QUESTION. But I also think it is a grand piano falling on the coyotes head. I can't stop it. Phase two will be how can I use it? The framework, however poorly executed in these initial forays may still offer us a TOOL for the practice of real medicine. I also believe in my little corner of the world, that if I can generate good OUTCOMES, (P4P criteria be damned, I mean the total outcome) then I can get my IPA to pay me a higher CAP rate. That doesn't help any of you that don't have the managed care we have in Calif. But it might help us all practice better medicine and it might pay you better at some point down the road.
