DFW Physician Executive Network tackles tough topic.

Pay for performance, always a controversial topic, was the subject that drew the largest crowd to date for the Dallas/Fort Worth Physician Executive Network dinner meeting on Sept. 19. Texas has had limited experience to date with P4P structured reimbursement designs, but it's expected to take off soon.

Carol Delage, president of the Tashidy Corporation, provided an external perspective of pay for performance. In her presentation, Delage highlighted current reimbursement methods in place, some of the more common challenges faced, as well as notable unintended consequences. She also provided insight on the increasing role that the Centers for Medicare and Medicaid Services will play in identifying quality metrics for P4P.

Next, to provide an internal perspective on rewarding quality metrics, David Ballard, MD, the senior vice president and chief quality officer for Baylor Health Care System, presented the findings from its internal P4P program that began in 2000. Baylor has had great success with its program, and encountered many of the same issues, challenges and unintended consequences outlined by Delage.

In a group discussion that followed, issues were explored around validity of data regardless of there origin, the role of patient compliance in quality metrics, and the potential of market-wide collaboration in the DFW area on setting common quality markers.