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Viewpoint |

Increasing the Value of Social Comparisons of Physician Performance Using Norms

Joshua M. Liao, MD1,5; Lee A. Fleisher, MD2,5; Amol S. Navathe, MD, PhD3,4
[+] Author Affiliations
1Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
2Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia
3Department of Medical Ethics & Health Policy, University of Pennsylvania, Philadelphia
4Corporal Michael J. Cresencz VA Medical Center, Philadelphia, Pennsylvania
5The Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania, Philadelphia
JAMA. 2016;316(11):1151-1152. doi:10.1001/jama.2016.10094.
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This Viewpoint proposes that reminders about professional standards might prevent counterproductive responses of physicians to report card comparisons intended to improve health care quality and reduce waste.

National policies, including the Medicare Access and CHIP [Children’s Health Insurance Program] Reauthorization Act of 2015, attempt to improve US health care by paying health systems and clinicians for value rather than volume of care. All payment systems, however, are susceptible to unintended consequences, and reimbursing physicians based on cost and quality outcomes may harm patients if financial and nonfinancial motivations are in conflict with each other.

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