Paying More Wisely: How Incentives Influence Physician Decisions at Point of Care
Time: Noon - 1 pm
Location: Scaife Hall, Lecture Room 3
Eugene Rich, MD, is director of Mathematica’s Center on Health Care Effectiveness. He is an expert on variation in medical practice with a particular focus on the influence of the policy, payment, and organizational environment on health professional decision-making. His longstanding interest in the role of evidence in general medical care has informed his policy work on primary care, payment reform, and comparative effectiveness research (CER) with over 120 publications on these topics. He also has deep practical experience with academic and clinical program leadership, including past roles as medicine department chair, and physician-hospital organization medical director.
Since joining Mathematica in 2010 he has led a number of projects, including the evaluation for HHS of the ARRA investment in CER, and the AHRQ effort to collect policy-relevant data on physicians and their practices. He serves key roles on several CMS contracts with Mathematica, including as Medical Officer for work on the physician value-based payment modifier; Senior Advisor for the Learning System for Medicare ACOs, and a Principle Investigator for the Evaluation of Primary Care Redesign.
Past recognition includes the Academy Health Article of the Year Award in 2001 and a 2007 Robert Wood Johnson Health Policy Fellowship working on physician payment reform for the House Committee on Ways and Means.
About This Session
This presentation will provide a framework for understanding how financial and nonfinancial incentives can complicate point-of-care decision-making by physicians, leading to the overuse or underuse of healthcare services.
By examining the different types of decisions that clinicians and patients make at the point-of-care, we will illustrate how incentives can distort decisions regarding testing, diagnosis and treatment, using examples from the "Choosing Wisely" program. We will review recent research and policy literature on the effects of payment policy reforms on clinical decision-making, examining such options as revised fee-for-service, pay-for-quality, episode-based payment and capitation. The potential advantages and disadvantages of these reforms will be considered in terms of their potential effects on diagnosis, testing, treatment and management of disease. We will conclude with a strategy for improving clinician incentives to better support evidence-based decisions at the point of care.
Continuing Medical Education
The University of Pittsburgh School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
The University of Pittsburgh School of Medicine designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Other health care professionals are awarded 0.10 continuing education units (CEUs) which are equal to 1.0 contact hours.
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