BLOGCAN - " When a Measurement Becomes a Target, It is no Longer a Valid Measurment"

On the Retired Doc's Thoughts blog, Dr James Gaulte offers some insight into the problems with scorecards for physicians or hospitals, and resulting pay-for-performance (P4P) schemes. The main idea comes from an economist: " Once a measure is made a target for the purpose of conducting policy, it will loose the information content that would qualify it to play such a role." The idea is once a measure becomes a quality or P4P target, it will be gamed, and pursuit of its improvement may lead to unintended consequences that can harm other aspects of quality.