Comments on: Advisory Group Adjust: Charles Milligan, Jr., Center for Health Program Development & Management http://www.tedeytan.com/2007/11/15/511 e-Health. Patient empowerment. Washington, DC. Tue, 06 Jan 2009 01:19:58 +0000 http://wordpress.org/?v=2.7 hourly 1 By: Josh Seidman http://www.tedeytan.com/2007/11/15/511/comment-page-1#comment-720 Josh Seidman Thu, 15 Nov 2007 13:56:59 +0000 http://www.tedeytan.com/2007/11/15/511#comment-720 I want to reiterate that that Chuck is entirely correct in his points about reimbursement and incentives. In the advisory group meeting, Chuck pointed out that there are both the immediate perverse incentives in most practice settings to engage in patient-centered care as well as the long-term issues related to enrollment churn that make it difficult to recoup investment in those interventions that have clear long-term financial rewards. In our shadowing, we have encountered some clinician reluctance to engage in secure messaging and related activities due to these perverse incentives, and we will continue to monitor it closely. Although the incentive structure is something that will be hard to address in the first phase of our PCHIT work, there is no doubt that it will be something for us to grapple with throughout and consider when we develop recommendations for advancing PCHIT implementation in the future. It also fits into the efforts of the IxAction Alliance's Ix Payer Workgroup. The Workgroup has developed a set of criteria regarding what constitutes information therapy (Ix) that we are sharing with accreditation, pay-for-performance (P4P), and provider recognition programs. The goal is to create more explicit market rewards for Ix and other patient-centered interventions in accreditation and P4P efforts. --Josh I want to reiterate that that Chuck is entirely correct in his points about reimbursement and incentives. In the advisory group meeting, Chuck pointed out that there are both the immediate perverse incentives in most practice settings to engage in patient-centered care as well as the long-term issues related to enrollment churn that make it difficult to recoup investment in those interventions that have clear long-term financial rewards.

In our shadowing, we have encountered some clinician reluctance to engage in secure messaging and related activities due to these perverse incentives, and we will continue to monitor it closely. Although the incentive structure is something that will be hard to address in the first phase of our PCHIT work, there is no doubt that it will be something for us to grapple with throughout and consider when we develop recommendations for advancing PCHIT implementation in the future.

It also fits into the efforts of the IxAction Alliance’s Ix Payer Workgroup. The Workgroup has developed a set of criteria regarding what constitutes information therapy (Ix) that we are sharing with accreditation, pay-for-performance (P4P), and provider recognition programs. The goal is to create more explicit market rewards for Ix and other patient-centered interventions in accreditation and P4P efforts.

–Josh

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