Paying for quality


Published: Sunday, December 1, 2002 at 6:01 a.m.
Last Modified: Saturday, November 30, 2002 at 9:51 p.m.
Boiled down, a new report to Congress from the National Academy of Sciences simply restates an old, old adage: You get what you pay for.
Or to be more precise, if Congress wants to improve the quality of health care provided under Medicare, Medicaid and several other federally funded programs, it ought to be willing to pay higher fees to attract the best doctors, hospitals and nursing homes.
"The federal government should take full advantage of its influential position to set the quality standard for the entire health care sector," Dr. Gilbert. S. Omenn, University of Michigan professor of medicine and chair of the study panel, told The New York Times recently.
That could be accomplished, the panel said, by linking pay to performance - by giving providers who adhere to specific quality criteria compensation of as much as 10 percent over standard payments.
This may not be a message that Congress wants to hear.
In recent years, payments to providers have been cut back, not increased, in the name of cost containment.
But if anything, current compensation rates are driving high-quality providers away from participation in federal health care programs.
Reversing that trend won't be cheap, but then, quality never is.

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