title: Extending the P4P agenda, part 2: how Medicare can reduce waste and improve the care of the chronically ill.
abstract: The care of Americans with severe chronic illnesses is disorganized, unnecessarily costly, and undisciplined by sound clinical science. The federal government should invest in a crash program to improve the scientific basis of managing chronic illness, and the Centers for Medicare and Medicaid Services (CMS) should extend its pay-for-performance (P4P) agenda to ensure that within ten years all Americans with severe chronic illnesses have access to accountable health care organizations providing evidence-based prospective care. This paper recommends a strategy for achieving this goal.
authors.affiliation: Dartmouth Institute for Health Policy and Clinical Practice, USA. john.e.wennberg@dartmouth.edu
authors.forename: John E
authors.initials: JE
authors.lastname: Wennberg
authors.forename: Elliott S
authors.initials: ES
authors.lastname: Fisher
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Skinner
authors.forename: Kristen K
authors.initials: KK
authors.lastname: Bronner
mesh_terms: D002908:Chronic Disease / Q000191:economics*; D019317:Evidence-Based Medicine; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D018854:Managed Competition; D006278:Medicare / Q000331:legislation & jurisprudence*; D012052:Reimbursement, Incentive / Q000331:legislation & jurisprudence*; D014481:United States