Less than Optimal and P4P in 2009
Happy New Year!
I wanted to get your input on a discussion I have been having with Selena and
Tim on Tim’s blog at http://physicaltherapydiagnosis.blogspot.com/2008/12/what-will-replace-optimal.html
Where are we in early 2009?
- Rumor has it that APTA’s Optimal is on life support
– Will it survive? Should it?
- In the letter from the APTA to Senator Max Baucus it
describes the APTA recognizing and supporting a transition from Pay for
Reporting (PQRI) to Pay for Performance. You thoughts on this fact and
also the letter from the APTA to President – Elect Obama.
- What do you think of this P4P model (old news but worth a second look).
My rant (will make more sense if you read the Optimal discussion on
Tim’s blog):
In my opinion, the current specific work groups and task forces working on
the best tool for P4P are spinning their wheels trying to recreate the
wheel. In his 12/23 blog post below, Larry has received only one comment
in response to his request for suggestions. Why not more? Perhaps
many do not really realize the potential long term implications of any tool
these groups develop?
I think pen and paper testing is antiquated and using the internet is
not a burden to 75% plus of our settings. In those settings where it is –
that is where paper backup can be used.
Using computer adaptive
testing appears to make sense in the same manner it does for the GRE.
With the CAT format, one can have a very large item bank of well researched
questions and then use item response theory to give the patient the least
amount of questions necessary. This is tried and true.
I also think you are on the road to El Dorado (paved with good
intentions) if you think a single generic paper questionnaire of only 20
questions will work across all body parts / conditions. However, paper
and pencil and a generic questionnaire are just what CMS appears to be leaning
towards.
I welcome your thoughts.
JW Matheson DPT
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