Impetus to Change
Many primary care physicians and groups want to provide excellent care. Obviously, with national quality benchmarks so low, we have proof that achieving the evidence-based standards are very, very difficult.
Some physicians are attracted to making changes purely for the satisfaction of seeing patients “at goal." Other physicians and groups are attacking medical quality as a key strategic maneuver. Being the best in market can help a group demand higher rates. It can also attract more patients if properly marketed. 
Yet other physicians find that local insurers, employer coalitions, state governments or others are demanding that medical group be “transparent” which means that they post their success and failure rates online for the public to see. In some markets, employers are forming preferential relationships with certain delivery systems based upon outcomes and costs.
The National Debate
Nationally, physicians who have been following the national healthcare debate have observed a great number of proposals about breaking the “fee for service” model and replacing it with various types of pay for performance, linked to outcomes. While it isn’t certain which model is likely to win, it seems very likely that outcomes will play an ever greater role in physician compensation across the country as it currently does in California, Minnesota, Wisconsin and other states.
We believe that being excellent in clinical care is an advantage for any physician group now and is likely to be a requirement for every physician group in the nearer future. We caution that achieving high quality scores, especially across several diseases, takes time even if you are provided the methodologies. It takes a very long time to develop these same results if you must invent the methods and implement them.
