WASHINGTON -- Quality measures used by patient-centered medical homes (PCMHs) and accountable care organizations (ACOs) don't work as well for children as they do for adults and can't be used to judge provider performance for both populations, a policy expert said here.
"Children are on an upward trajectory," said David Keller, MD, Center for Health Care Policy and Reform at the University of Massachusetts Medical School in Quincy. "We're worried not about cushioning the fall, which is what most adult medicine is about. We're worried about maximizing the rise."
Therefore, performance payments that accompany PCMHs and ACOs -- payments which are or can be heavily based on outcomes -- present the biggest challenge for pediatricians, he said at the Pediatric Academic Societies annual meeting here. For adults, the goal is easily defined: trying to prevent death.
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