Extending the P4P agenda, part 2: how Medicare can reduce waste and improve the care of the chronically ill

Health Aff (Millwood). 2007 Nov-Dec;26(6):1575-85. doi: 10.1377/hlthaff.26.6.1575.


The care of Americans with severe chronic illnesses is disorganized, unnecessarily costly, and undisciplined by sound clinical science. The federal government should invest in a crash program to improve the scientific basis of managing chronic illness, and the Centers for Medicare and Medicaid Services (CMS) should extend its pay-for-performance (P4P) agenda to ensure that within ten years all Americans with severe chronic illnesses have access to accountable health care organizations providing evidence-based prospective care. This paper recommends a strategy for achieving this goal.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chronic Disease / economics*
  • Evidence-Based Medicine*
  • Health Care Costs
  • Health Expenditures
  • Humans
  • Managed Competition*
  • Medicare / legislation & jurisprudence*
  • Reimbursement, Incentive / legislation & jurisprudence*
  • United States