On the subject of P4P...

After reading the NYT article that Kim posted on the pitfalls of P4P, I started wondering how Great Britian's P4P system is structured.  For anyone who watched the Frontline video of the primary physician that was interviewed, he seemed pleased with the bonuses he received from producing better health outcomes for his patients.  The video presented what seemed like a flawless view of the P4P system in Great Britain.  From what I gathered, the way P4P works in countries like Great Britain and New Zealand is that the P4P goals are adjusted by economic status of the surrounding community in which the clinic is located.  This is predicated on the knowledge that lower socioeconomic patients have poorer health than patients with higher socioeconomic status.  In this way the P4P system does not create disincentives for physicians to work in underserved communities if they're not meeting their P4P goals.  Any thoughts of whether this aspect of P4P could work in the U.S.? 

Here is the article that talks about this:   

http://www.minnesotamedicine.com/PastIssues/April2006/CommentaryApril2006/tabid/2386/Default.aspx