Basing physician compensation on a pay-for-performance model “simply doesn’t work,” according to a Vox article written by Harvard Medical School population health professor Stephen Soumerai, ScD, and University of Pennsylvania health IT researcher Ross Koppel, PhD.

The professors classify such models as a “failure” and argue they may even lead to physicians avoiding treating sicker patients to ensure they receive bigger performance bonuses.

“They reward doctors for things they already do, like prescribing antihypertensive drugs. What’s more, the programs often use lousy, unreliable quality measures: For example, they might penalize doctors for not prescribing antibiotics to patients who are allergic to them. More troubling, there is evidence that such policies may even harm patients by encouraging unethical practice,” they wrote.

The solution, the pair argues, is more closely scrutinizing what they consider to be flawed research on these models’ effects on patient outcomes and focusing on identifying reasons for poor performance, not tying it to what a doctor makes.

For more on their harsh critique of these compensation models, including the broad changes made by the Medicare Access and CHIP Reauthorization Act (MACRA), click on the link below: