In these days when pay-for-performance and value-based payment reform have become the centerpiece of US Medicare payment reform, this short and accessible article in JAMA Health Forum (5 minutes) argues that we implement and evaluate reforms using “policy equipoise” rather than the usual foundational belief – that too many economists adhere to – that these policies must work because the models economists use predict they should because of the incentives they create. The paper provides links highlighting that in many cases these reforms have very mixed or no success. Policy equipoise – the acceptance of true uncertainty about whether one policy is better than another in a given situation – should guide randomized designs to generate more convincing evidence about what works. Check out its links for a systematic review of (y)our favorite US payment reform: VPB, P4P, ACO, bundled payments.
Jonathan A. Staloff, MD, MSc1,2; Amol S. Navathe, MD, PhD3,4; Joshua M. Liao, MD, MSc1,2
I happened upon the above article after reading this one, which is also interesting (3 minutes).
Anita Slomski, MA