New Strategies for Medical Data Mining, Part 1: Dynamic and Performance-Based Reimbursement

Abstract

The current professional reimbursement model within medicine was created more than 20 years ago in response to physician dissatisfaction and health care inflationary pressures. Despite many resulting improvements, several deficiencies currently exist within the current reimbursement model, related to transparency, accountability, and quality. As the tenets of evidence-based medicine and pay for performance become ingrained within health care delivery, it would be beneficial to modify the existing reimbursement model to reflect these principles. The opportunity to accomplish this goal is advanced through the continued evolution of information systems technologies and data mining. The author discusses the existing deficiencies in medical reimbursement and makes a number of recommendations for improvement. The ultimate goal is to incorporate objective and standardized data into a transparent and readily accessible database, which can be used to enhance performance, education, and informed decision making.