1. How to Practice Thoracic Surgery in the Pay for Quality Era Douglas E. Wood Alessandro Brunelli Stephen D Cassivi Claude Deschamps Shaf Keshavjee Cameron D Wright

2. “Doctors and health policy experts have begun to take stock of the practical implications of the legislation, which seeks to move away from paying doctors solely on the volume of their services and toward reimbursing them based on the quality and value of the care they provide……that, beginning in 2019, would pay doctors based on how they perform on quality and other measures. Ultimately, the Department of Health and Human Services will decide those standards.”

3. “Pay-For-Performance,” Health Affairs, October 11, 2012 http://www.healthaffairs.org/healthpolicybriefs/

5. Pay for Quality Cam - Should process or outcome measures be used for quantifying quality of patient care? Alex – Can outcome measure be risk adjusted? Should they? Steve –Are surgeons “responsible” for the quality, or is it a more complex system delivery of care with surgeons only one of many accountable providers? Shaf – What are the unintended consequences of “standardization” of care? Does it stifle innovation? Are there ways to mitigate this problem? Claude - Which compensation plan is best suited to help in the transition to population management/pay for quality era? Steve - Should we use relatively easy measures that pull data from administrative data vs more complex measures in clinical databases that really measure health care quality? Cam – What should our surgeons or our specialty societies do to inform and influence policy-makers about how to get it right?