Gentlemen,

Congrats on an excellent piece. This is one of the few that actually catches the latest and greatest of hospital VBP. Good job.

There is something obvious, however, that weighs heavy on the minds of hospital administrators but requires clarification among physicians- that is, the eventual shift of hospital (and soon physician) quality measures to performance metrics. In practical terms, doctors understand the basics of qm’s but seem less able to grasp that Medicare incentives will ultimately be tied to actual patient outcomes and health status. When I lecture, I often give very simple conversions of qm’s to performance metrics using the Acute Myocardial Infarcton qm’s as template…that’s becasue it’s one of the easier of the qm’s to grasp. The movement towards true P4P is a concept that can never be oversimplified. Always remember that physicians deal in terms of logic and rationale…never common sense. There are certain issues where the obvious can never be overstated.

I do have a question how much weight you think the Feds will give to the 30-day mortality rates with regards to overall performance. Common sense suggests that it will be paramount (but I’m a physician not blessed with the virtues of common sense).