The program, which was introduced in the early 1990s, was intended "to improve the quality of cardiac surgery by pointing out deficiencies in hospitals and surgeons; those who did not measure up would be forced to improve," according to Jauhar. However, studies on the program "demonstrated there was a significant amount of 'cherry-picking' of patients in states with mandatory report cards," Jauhar writes. "With surgical report cards, surgeons' numbers improved not only because of better performance but also because dying patients were not getting the operations they needed," he writes, adding, "Pay for performance is likely to have similar repercussions."
Norman DeLisle, MDRC
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