Grading a Physician's Value — The Misapplication of Performance Measurement

By 2017, the value-based payment modifier will be used to reward or penalize all Medicare physicians on the basis of the relative calculated value of the care they provide. But a physician's overall value cannot be assessed with current or foreseeable measures. Perhaps the only health policy issue on which Republicans and Democrats agree is the need to move from volume-based to value-based payment for health care providers. Rather than paying for activity, the aspirational goal is to pay for outcomes that take into account quality and costs. In keeping with this notion of paying for value rather than volume, the Affordable Care Act (ACA) created the “value-based payment modifier,” or “value modifier,” a pay-for-performance approach for physicians who actively participate in Medicare. By 2017, physicians will be rewarded or penalized on the basis of the relative calculated value of the care . . .