''The real money, many health economists believe, may come from reorienting the payment system to encourage prevention and chronic disease management and to discourage unnecessary procedures. The two major-party presidential candidates support such a realignment, a rare point of consensus in a polarized health care debate.

"This is a specific case of the larger pay-for-performance trend, the idea that you should pay more for quality than lack of quality, or in this case pay less for defects," said Dr. Donald Berwick, president of the Institute for Healthcare Improvement. "This whole trend is like a juggernaut, and it is not going to stop."

Medicare now grants bonuses to doctors and hospitals reporting quality measures. It is experimenting with rewarding physicians who follow protocols for treating diabetes, coronary artery disease and congestive heart failure. The Medicare Payment Advisory Commission, an arm of Congress, recently recommended reducing payments to hospitals with high readmission rates.''

http://www.iht.com/articles/2008/10/...

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