“The spread of pay-for-performance payment” and adoption of health IT tools raise “concern that physicians might” engage in “cherry-picking” and “lemon-dropping behaviors,” Carson Strong and Jim Bailey — professors in the Department of Medicine at the University of Tennessee Health Science Center — write in an American Medical News opinion piece.
Cherry-picking refers to the practice of selecting healthier individuals to accept as patients in an effort to meet performance criteria and keep medical practice costs down. Lemon-dropping or “patient dumping” refers to terminating care for patients who could be more costly or difficult to treat.
Strong and Bailey write, “The widespread adoption of [electronic health records] will provide physicians with powerful new tools for data mining that could assist in selection of profitable patients.” They write, “Lemon-dropping can be conducted easily with a highly functioning [EHR] system that includes registries for patients with chronic diseases,” adding that federal privacy rules “do not specifically prohibit these activities.”
However, Strong and Bailey write that “[p]atient selection of this sort is unethical on many levels.”
Reasons Behind Argument
According to Strong and Bailey:
Recommendations
Strong and Bailey provide three recommendations for dissuading cherry-picking and lemon-dropping behaviors:
Source: iHealthBeat
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