Pay for performance (P4P) -- the UK experience

I've finally (and thankfully) gotten a chance to read the web article by Robert Galvin: "Pay-For-Performance: Too Much Of A Good Thing? A Conversation With Martin Roland." Health Affairs, September/October 2006; 25(5): w412-w419.

Galvin interviews Martin Roland, an advisor to the "world’s most ambitious P4P program," the United Kingdom’s Quality and Outcomes Framework (QOF). Roland discusses the unexpected results and findings of the QOF and offers some advice to the United States. Even though the UK and US health care delivery systems differ, it is still very worthwhile information. One important point that Roland makes is that exception reporting "was introduced on the basis that if you have some form of evidence-based guideline, nobody would ever suggest that it should be applied to all patients. So, for example, if you’ve got a diabetic who’s dying of cancer, you’re not going to try and get his cholesterol down."

I encourage all who are involved in CME to read this important article; check with your medical librarian to see if your institution already subscribes to Health Affairs (or this article can be purchased online for a nominal fee).

What a boost to primary care in the UK!