Meredith Rosenthal, Ph.D. is Assistant Professor of Health Economics and Policy in the Department of Health Policy and Management. Dr. Rosenthal received her Ph.D. in health policy at Harvard University in 1998. Dr. Rosenthal's principal research interests revolve around economic incentives that influence consumer and provider health care decisions. Her other substantive interests include the pharmaceutical industry, mental health policy, and the economics of smoking. She is currently working on a series of related projects that examine evolving trends in the health insurance market, including consumer-directed health plans and financial incentives for improving health care quality and patient safety.

Question #1:

In your opinion, what are the most significant obstacles to achieving and rewarding provider quality?

I would say the most significant obstacles to achieving and rewarding provider quality are (1) identifying performance measures that are valid, difficult to game, and capture a meaningful scope of practice (many measures or sets of measures are one or the other but not all three), and (2) getting enough critical mass (in both dollars and payers) to make it worthwhile for providers to make the necessary investments to change.

Question #2:

In your opinion, what are the most forward thinking initiatives or solutions that should be widely explored to achieve the systematic change necessary for successful pay-for-performance?

I think the IHA's initiative is a model both for achieving a critical mass of payers and for setting up a multiple stateholder process for measure selection and other program aspects that seems to work effectively.

Question #3:

Please expand on any initiatives with which you are currently involved that benefit your organization or the health care industry.

I am involved in several evaluations of pay-for-performance, public reporting, and performance-based networks. We are assessing the impacts of these strategies and providing guidance to health plans and purchasers on the most effective ways to implement these tools separately and in combination.

Question #4:

Please provide highlights of your presentation at the Leadership Summit and any preliminary results or data that can be shared.

I will be moderating the session on barriers to effective pay-for-performance. I hope we will hear from some early adopters about their experience in the field both in terms of what worked and what didn't - is there insufficient IT in the marketplace to achieve much performance change? Do the providers think there is enough money on the table? How are programs adapting to overcome early obstacles?

Question #5:

Please state what you hope to achieve by participating in the 3rd Annual World Congress Leadership Summit on Health Care Quality and Pay for Performance Contracting.

I hope to learn more about what is going on in the practice of pay-for-performance contracting and what the early experiences suggest about the direction of second-generation programs.