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Editor's perspective.

Article Excerpt
A growing emphasis is being placed by managed care organizations and employers on attempting to encourage providers to more aggressively focus on quality of care in order to reduce overall health care costs. More attention is being placed on the concept of pay-for-performance. It is a system of accountability that measures the performance of health care providers and rewards those providers for following clinical guidelines and achieving positive clinical outcomes. Pay-for-performance is viewed by managed care organizations and employers as a sound business approach for achieving excellent clinical outcomes in a cost-effective manner. "Health plans historically have measured provider performance, but the focus has almost exclusively been on overutilization review and external controls," says Jeffrey Hanson, vice president and pay-for-performance leader for Thomson Medstat.

The problem some note with the typical "provider profiling" approach is that it narrowly focuses on overutilization and encourages service reduction...

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