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Pay for Performance

RESOLVED, That the North Carolina Medical Society supports Pay for Performance programs provided the following principles are incorporated:

  1. The program design focuses on improved quality and safety, using evidence-based, broadly accepted, clinically relevant, continually updated, quality of care measures, particularly those developed by the AMA Physician Consortium, and allows for, without penalty, variations in individual patient care regimens based on a physician’s sound clinical judgment;
  2. The program adequately adjusts for patient mix so that physicians are encouraged to accept, treat, and retain all patients regardless of health conditions, ethnicity, economic circumstances, demographics, or treatment compliance patterns (fosters the physician-patient relationship and supports continuity of care);
  3. Physicians and physician professional organizations have meaningful input into the program design and enhancements;
  4. The program is voluntary and will not adversely affect physicians who elect not participate;
  5. The program uses accurate and reliable data (preferably the use of encounter data instead of claims data), and scientifically valid analytical reporting methods, and provides physicians with an opportunity to review, comment, and appeal results prior to the use of results for program incentives and reporting; and
  6. Clear and positive incentives are employed that are not budget neutral or “zero-sum” but rather provide new funds from expected savings that are adequate to offset needed infrastructure changes and enhancements and reward quality care; the incentives must be clearly and accurately explained; and be it further

RESOLVED, That the North Carolina Medical Society supports uniform evidence-based performance measures across all Pay for Performance programs.

(Report I-2006, adopted 10/29/2006)
(reaffirmed, Report H-2011, Item 3-17, adopted 10/23/2011)