Online Program

Oral

Steffie Woolhandler, MD, MS, a primary care physician, is a hero of the struggle for national health insurance.  She has been director of quality teaching for Cambridge Hospital and written many articles related to our vision of quality.  Although we don’t first think of quality in her work (more often we think about access, insurance, administrative waste, or medical bankruptcy), she has published many excellent articles on quality issues, e.g., co-pays as quality barriers, HEDIS measures and for-profits, drug side effects and black box labeling, quality and P4P (pay for performance).   Dr. Woolhandler earned her bachelor’s degree from Stanford University, a medical degree from Louisiana State University, and a master’s degree from the University of California. In 1990-1991 her position was at the Institute of Medicine and the US Congress as a Robert Wood Johnson Foundation health policy fellow.  She was a professor of medicine at Harvard and now is at the CUNY School of Public Health. Her remarks in this session pertain to pay-for-performance models. Pay-for-performance (P4P) programs aim to upgrade health care quality through financial incentives for desirable behaviors. This intuitively attractive approach rests on questionable assumptions about medicine, measurement and motivation; and evidence of effectiveness is lackluster at best. Yet payers and policymakers have pushed ahead, implementing everywhere policies that have yet to work anywhere. Dr. Schiff will will summarize his presentation to the Institute of Medicine committee experts empaneled to review the topic of diagnostic errors in medicine. He will discuss broader aspects of health care reform related to diagnostic errors and quality of care.  Principles developed by Dr. Donabedian will serve as the framework and context for the presentation.

Session Objectives: Participants will learn the definition of pay for performance with respect to financing health care groups. Due to this session they will be able to name assumptions underlying this model and explain why they are faulty. The session will identify sources and kinds of errors often found in health care that compromise its quality.

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)