Aligning physician incentives with goals of patients

This is the most difficult, some would say "only," issue in health care management. Physicians have the information necessary to make good decisions, but their decisions are influenced by their incentives. Now some companies with big health care expenses are trying to change physican incentives. From WSJ:

...reward primary-care physicians significantly more than that, but they would be required to make much bigger changes and adopt a more integrated approach to coordinating patients' care. Such steps include following up on referrals to other physicians, systematically tracking tests, flagging abnormal results and adhering to widely accepted medical guidelines to monitor and treat diabetes and other chronic conditions.

By using such processes to improve and better coordinate care, doctors can receive $125 annual bonuses for each patient covered by a participating employer, up to a maximum $100,000 a year. Based on previous work with doctors' practices, Bridges to Excellence executives estimate such improvements in quality save $250 to $300 per patient in the first year.