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May 5, 2019

Physicians Respond to Accurate, Actionable Data on Their Performance

Author Affiliations
  • 1Department of Dermatology, University of California San Francisco School of Medicine, San Francisco
  • 2Philip R. Lee Institute for Health Policy Studies, University of California San Francisco School of Medicine, San Francisco
  • 3Department of Dermatology, University of Iowa, Iowa City
JAMA Dermatol. 2019;155(8):881-883. doi:10.1001/jamadermatol.2019.0845

Efforts to improve quality and reduce cost in US health care delivery have proliferated since the publication of To Err is Human1 2 decades ago. Many interventions driven by commercial and government payors realigned incentives by tying performance to payment bonuses or penalties, publicly reporting results, or by introducing financial risk sharing. Some strides have been made in reducing medical errors, coordinating care, infusing quality and safety into the culture of care delivery, engaging patients as quality partners, and creating some value-based alternative payment models to spur innovation. However, there is also evidence of proliferating, unfocused measures, unsustainable reporting burdens, unintended consequences, and a loss of confidence—even among some ardent supporters—that many of these interventions are accomplishing their goals despite the billions of dollars spent and health system bandwidth consumed.2-6