Extending the P4P agenda, part 2: how Medicare can reduce waste and improve the care of the chronically ill.
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.
Wennberg
John E
JE
Dartmouth Institute for Health Policy and Clinical Practice, USA. john.e.wennberg@dartmouth.edu
Fisher
Elliott S
ES
Skinner
Jonathan S
JS
Bronner
Kristen K
KK
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