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Volume 356:872-873 February 22, 2007 Number 8
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Pay for Performance in Commercial HMOs

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by Rosenthal, M. B.
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To the Editor: In their discussion of pay for performance, Rosenthal et al. (Nov. 2 issue)1 set up a troubling implication regarding attribution of performance for patients who are cared for by multiple physicians. They imply that such attribution is more feasible when patients have a designated primary care physician. Yet is it reasonable to hold primary care physicians accountable for care provided by others?

Primary care physicians had the misfortune of being gatekeepers in the 1990s, a role that did not enhance the attractiveness of general practice. Will they now become the street sweepers in the new realm of . . . [Full Text of this Article]



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