Dr Mitzi Wasik on the Importance of Physician Influence in P4P

The shift to a pay-for-performance environment healthcare gets the provider more involved with the patient, which has a greater impact on quality measures like adherence, said Mitzi Wasik, PharmD, BCPS, director of Pharmacy Medicare Programs at Aetna, Inc.

Transcript (slightly modified for readability)

How does pay-for-performance support the accountability of patient care?

The fact that we’re shifting away from a “do more, pay more” type philosophy should get the providers engaged and wanting to do more with their patients, because we’re paying for the quality, not the quantity.

The provider may not get paid for the actual time they spent counseling, but if they’re reimbursed for the adherence to the medication by the patient at the end of the year, or whatever the timeframe is, then they’re more likely to be involved with that patient. And historically, if a patient is seeing a physician, the physician will ask, “Are you taking your medications” and there’s so much going on and so little time for the physician to actually work with the patient, that they may not know that the patient missed 2 weeks of their medication and tying that to adherence at the end of the year, they might be more apt to ask those types of questions and build it more into the practice.

And at the end of the day it comes down to the physician influence. So if a patient gets a call from a health insurer or PBM, they don’t have that personal relationship, whereas if a physician, or a physician staff that they know well, is calling them and asking them about their adherence behaviors, they are more likely to feel like they got sent to the principal’s office, and they are more likely to continue to take their medication and have that open discussion with their physician. And I think the physician influence is key in all of these metrics that we’re looking at in quality, and they really are the pinnacle of getting the patients to a healthier place.