Senior author Stephen Soumerai, professor in the Department of Population Medicine at Harvard Medical School and Harvard Pilgrim Health Care Institute, believes the data is generalizable. The evidence – and his own experience – supports that physician behavior is largely similar, he says.
Soumerai is profoundly skeptical about pay-for-performance based on the findings.
What's particularly troubling to him is that such policies are being implemented without any evidence to support their effectiveness.
It comes down to basing your decision on evidence, he explains. The Obama administration has stated that science should be the basis of policy, but, he says, in the case of pay-for- performance, there's no evidence backing the policy.
It's a global problem, Soumerai says: Governments and private insurers throughout the world are likely wasting many billions on such policies.
"Significant pilot testing" is needed, he says: And it wouldn't have to take too long–eight months before and after P4P implementation would be adequate. "If the administration wants to live up to its promise that science is the basis of policy, then we need data."