Performance Measures are Severely Misguided

It is not currently possible to measure outcomes correctly. This is particularly true in small practices with too few patients in whatever subset is being measured. Also, patient performance, and thus outcomes, are only partially dependent on their doctor.
The payment model in Denmark appears to be well accepted by physicians. The primary care practices are largely privately owned, and there is a fee for services regardless of whether it is email, phone or face-to-face. Physicians are additionally given a PPPM. A small "performance" bonus is available, of which I am not clear on the details. I was under the impression the bonus payment, based on “performance,” measures was low, and there were measures of patient satisfaction included. It is my prediction that the PCMH models that succeed in the U.S. will be very similar to this. In Denmark, there is over 90% physician satisfaction. The PCMH model in the U.S. could largely reproduce this, if (big if) physicians can adapt quickly enough.
Physician acceptance will follow the pattern as Moore describes in Crossing the Chasm. My concern is less that most physicians will adapt, because they will as long as it is a win for them and their patients. My concern is if the rate of physician adaptation can be rapid enough considering the demoralization and skepticism they have (and for good reason). As always, there will always be a vocal class of laggards whose noise can slow healthy adaptation by the majority.
My greater concern with the transition to value-based payment systems is that the current power elites in the healthcare system will succeed in promoting ACO models that are not founded on PCMH principles. This will fail, and I encourage physicians to oppose these vigorously.