The question is: how do you measure performance?

The government wanted to issue some guidelines on how to quit smoking, and corporate interests seem to have influenced what it said, an article published in Feb 8, 2007 Wall Street Journal (WSJ) says. The guidelines are seen as gospel by many. It is an open secret that vested interests work hard on influencing the guidelines. Many well-respected medical organizations issue guidelines on important health issues from time to time. Some have raised concern that many people responsible for issue of guidelines also work closely with big companies.
Pay for performance (P4P) is a simple and attractive idea: the health provider (hospital or physician) that performs better should be compensated better. Who can argue with that? The problem is that it is hard to find good yardsticks for measuring health care quality. Many of these yardsticks are created based on guidelines. If the guidelines are going to be flawed as the WSJ report suggests, how can we expect pay for performance measures to be fare? We need to work hard on the right criteria for measuring performance before we go too far with P4P. Otherwise, we run the risk of penalizing some genuine performers and rewarding those that are simply good exam-takers.
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