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The rationale behind pay for performance (PFP) initiatives is that payers, both public and private, want to pay only for care that has proven benefit. Choosing which clinical conditions and metrics to include in PFP programs has been challenging; the initiatives developed to date have yielded mixed results and have generated much consternation and debate.
In response to the Centers for Medicare and Medicaid Services (CMS) initiation of PFP programs for cardiovascular care, the American College of Cardiology/American Heart Association (ACC/AHA) published methodology for categorizing the level of evidence for the selection and creation of quality and performance measures. The assessment involves four criteria:
Strength of the evidence supportin…