Andrew L. Pecora, MD
To optimize clinical outcomes and reduce the total cost of care, it is important to limit physicians’ choices of care. The current belief is that, in the fee-for-service world, physicians have a perverse incentive to overtreat patients: the more they do, the more money they will make; and because they are paid based on the amount of care rather than the value of care, they will do more than is necessary to achieve the ideal outcome. This is probably happening in some—but not all—circumstances. Conversely, undertreatment can lead to less-than-optimal clinical outcomes and a greater total cost of care. Over- and underutilization of care are each considered a form of adverse variance. The question is how best to prevent this.
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