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Pay-for-Performance and Accountability
TO THE EDITOR:
In his article, Rowe (1) makes several important points about value-based purchasing, especially the need to develop meaningful measures for complex patients and the tension between rewarding the absolute level of achievement versus the degree of improvement. Four assumptions in the paper, however, deserve comment: the assumptions that health information technology is the cure for quality, that extra patients aren't really extra work, that primary care physicians are not specialists, and that performance measurement should be focused at the physician level.
First, the author …
