The healthcare industry broadly agrees that payment reform is key to healthcare reform, according to Tuesday's keynote speaker at the National Pay for Performance Summit.
The questions, however, are whether pay-for-performance, or P4P, will result in better value and who will lead the movement, said Robert Galvin, MD, director of Global Healthcare for GE Corp.
Galvin, who is also a founding member of The Leapfrog Group and vice chair of the Washington Business Group on Health, applauded the "stunning" number of P4P projects and initiatives across the country.
He warned, however, that without coordination and input from the private sector, the industry runs the risk of unintended consequences and growing chaos if payment rates are wildly different, which may lead to termination of these efforts.
"The devil is in the details," Galvin said, referring to the variations in who pays, and on what basis, across initiatives.
P4P advocates need to be aware of the powerful, vested interests and to understand that whatever Medicare does, because of its significant influence, the industry tends to follow. "Payment reform leaders need a voice," Galvin said.
Galvin believes effective leadership will come from the Center for Payment Reform, or CPR, which he founded eight months ago as an initiative of the Consumer-Purchaser Disclosure Project. CPR comprises consumers, labor, purchasers, willing providers and policymakers.
In 2009, CPR's goals are to create principles and a roadmap for the P4P industry and facilitate alignment between the public and private sectors. Galvin said he hopes that establishing a national scorecard for payment and the coordination of local initiatives will be later projects.
CPR's "playbook" for payment reform will look at different strategies and options, measure the relative value of each strategy/option and establish detailed recommendations. Galvin anticipates circulating the principles, creating and finalizing the roadmap and then getting sign-on from members this year.
CPR will also map out current processes for payment in the public and private sectors, outline policy options and make specific process recommendations for the industry.
The Fourth National Pay for Performance Summit, sponsored by the Integrated Healthcare Association and co-sponsored by Bridges to Excellence, Leapfrog Group, the National Business Coalition on Health, the National Committee of Quality Assurance and the National Quality Forum, concluded in San Francisco Wednesday.