“Value-based purchasing is built on the premise that audit providers feeding them back information on their performance has been not sufficient,” says Ateev Mehrotra, MD, MPH, associate professor of healthcare policy and medicine at Harvard Medical School and a hospitalist at Beth Israel Deaconess Medical Center. In theory, if a physician were told he or she had performed poorly on a particular measure there would be a reaction and change, but he admits this is not supported by the evidence. For some reason, “audit and feedback” does not make too much of a difference with providers.
Arthur Vercillo, MD, FACS, regional president, Excellus Blue Cross Blue Shield, does not agree that providers were not influenced when presented with value-based practice data. He believes that although they initially resist changing how they practice, “When you look at the behavior later it does change.”
According to Francois de Brantes, MS, MBA, executive director of the Healthcare Incentives Improvement Institute, providing appropriate feedback to providers is now no longer a luxury but a necessity. He cites the example of a group of orthopedic surgeons who were shown their performance data as part of a value-based purchasing program—their basic takeaway was, “All those non—evidence-based things that we knew we shouldn’t do, we finally have a reason not to do.” Mr de Brantes added that many payers have driven incentives against professionalism for decades, “and they are beginning to realize that it may not be a good idea.”