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Incentive compensation

Justin B Bullock, W David Bradford
Adequate access to primary care is not universally achieved in many countries, including the United States, particularly for vulnerable populations. In this paper we use multiple years of the U.S.-based Community Tracking Survey to examine whether a variety of physician compensation structures chosen by practices influence the likelihood that the practice takes new patients from a variety of different types of insurance. Specifically, we examine the roles of customer satisfaction and quality measures on the one hand, and individual physician productivity measures on the other hand, in determining whether or not firms are more likely to accept patients who have private insurance, Medicare, or Medicaid...
March 2016: Int J Health Econ Manag
Nadia Awad, Francis J Caputo, Jeffrey P Carpenter, James B Alexander, José L Trani, Joseph V Lombardi
OBJECTIVE: Given the increased pressure from governmental programs to restructure reimbursements to reflect quality metrics achieved by physicians, review of current reimbursement schemes is necessary to ensure sustainability of the physician's performance while maintaining and ultimately improving patient outcomes. This study reviewed the impact of reimbursement incentives on evidence-based care outcomes within a vascular surgical program at an academic tertiary care center. METHODS: Data for patients with a confirmed 30-day follow-up for the vascular surgery subset of our institution's National Surgical Quality Improvement Program submission for the years 2013 and 2014 were reviewed...
November 19, 2016: Journal of Vascular Surgery
Susan A Chapman, Lisel K Blash
OBJECTIVE: To identify and describe new roles for medical assistants (MAs) in innovative care models that improve care while providing training and career advancement opportunities for MAs. DATA SOURCES/STUDY SETTING: Primary data collected at 15 case study sites; 173 key informant interviews and de-identified secondary data on staffing, wages, patient satisfaction, and health outcomes. STUDY DESIGN: Researchers used snowball sampling and screening calls to identify 15 organizations using MAs in new roles...
November 10, 2016: Health Services Research
Alyse Kittner, Terese Hudson Thrall
The American Organization of Nurse Executives conducted its 2nd salary and compensation survey of nursing leaders in 2016. Annual salaries from responding nurse leaders vary largely, with half falling between $90000 and $149999. Two-thirds of the respondents are eligible for an incentive. Overall job satisfaction was high among nurse leaders.
December 2016: Journal of Nursing Administration
Eric W Djimeu, Annette N Brown
BACKGROUND: Seven new impact evaluations of pilot programs for increasing the demand for voluntary medical male circumcision (VMMC) provide evidence of what works and what does not. The study findings suggest that financial compensation designed to relieve the opportunity or transportation costs from undergoing the procedure can increase the uptake of VMMC. There is also evidence that programs using peer influence can be effective, although so far only sports-based programs demonstrate a strong effect...
October 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Christopher R Dale, Michael Myint, Amy L Compton-Phillips
A physician in our medical group recently complained about the quality-based component of his pay: "I spent 2 1/2 hours last night looking at my compensation statement, and I found 12 patients that shouldn’t have been included [on my list]," he lamented. He’d narrowly missed his payout threshold..
August 18, 2016: New England Journal of Medicine
M Ruth Lavergne, Michael R Law, Sandra Peterson, Scott Garrison, Jeremiah Hurley, Lucy Cheng, Kimberlyn McGrail
BACKGROUND: In 2007, the province of British Columbia implemented incentive payments to primary care physicians for the provision of comprehensive, continuous, guideline-informed care for patients with 2 or more chronic conditions. We examined the impact of this program on primary care access and continuity, rates of hospital admission and costs. METHODS: We analyzed all BC patients who qualified for the incentive based on their diagnostic profile. We tracked primary care contacts and continuity, hospital admissions (total, via the emergency department and for targeted conditions), and cost of physician services, hospital care and pharmaceuticals, for 24 months before and 24 months after the intervention...
October 18, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Marcel Yotebieng, Harsha Thirumurthy, Kathryn E Moracco, Andrew Edmonds, Martine Tabala, Bienvenu Kawende, Landry K Wenzi, Emile W Okitolonda, Frieda Behets
BACKGROUND: Novel strategies are needed to increase retention in prevention of mother-to-child HIV transmission (PMTCT) services. We have recently shown that small, incremental cash transfers conditional on attending clinic resulted in increased retention along the PMTCT cascade. However, whether women who receive incentives to attend clinic visits are as adherent to antiretrovirals (ARV) as those who do not was unknown. OBJECTIVE: To determine whether HIV-infected women who received incentives to remain in care were as adherent to antiretroviral treatment and achieved the same level of viral suppression at 6 weeks postpartum as those who did not receive incentives but also remained in care...
August 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Ellen Montz, Tim Layton, Alisa B Busch, Randall P Ellis, Sherri Rose, Thomas G McGuire
Under the Affordable Care Act, the risk-adjustment program is designed to compensate health plans for enrolling people with poorer health status so that plans compete on cost and quality rather than the avoidance of high-cost individuals. This study examined health plan incentives to limit covered services for mental health and substance use disorders under the risk-adjustment system used in the health insurance Marketplaces. Through a simulation of the program on a population constructed to reflect Marketplace enrollees, we analyzed the cost consequences for plans enrolling people with mental health and substance use disorders...
June 1, 2016: Health Affairs
Phillip Miller, Kurt Mosley
To a significant degree, "healthcare reform" is a movement to change how both physicians and healthcare facilities are compensated, with value replacing volume as the key compensation metric. The goal of this movement has not yet been accomplished, but the process is accelerating. In this article, we track how the arc of physician compensation is bending, how the Medicare Access and CHIP Reauthorization Act will drive further changes to physician compensation models, and how these changes may affect physician practice patterns and physician staffing in the future...
March 2016: Journal of Medical Practice Management: MPM
Robert G Evans
The correlation between health and wealth is arguably a very solidly established relationship. Yet that relationship may be reversing. Falling oil prices have raised (average) per capita incomes, worldwide. But from a long-run perspective they are a public health disaster. The latter is easy to see: low oil reduces the incentive to develop alternative energy sources and "bend the curve" of global warming. Their principal impact on incomes has been redistributional - Alberta and Russia lose, Ontario and Germany gain, etc...
May 2016: Healthcare Policy, Politiques de Santé
Eleonora Fichera, Ewan Gray, Matt Sutton
The efficacy of the management of long-term conditions depends in part on whether healthcare and health behaviours are complements or substitutes in the health production function. On the one hand, individuals might believe that improved health care can raise the marginal productivity of their own health behaviour and decide to complement health care with additional effort in healthier behaviours. On the other hand, health care can lower the cost of unhealthy behaviours by compensating for their negative effects...
June 2016: Social Science & Medicine
Sachin M Apte, Kavita Patel
With the signing of the Medicare Access and CHIP Reauthorization Act in April 2015, the Centers for Medicare and Medicaid Services (CMS) is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology-related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology-specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations...
2016: Frontiers in Oncology
Emile Tompa, Chris McLeod, Cam Mustard
OBJECTIVES: The aim of this study was to compare the association between insurance premium incentives and claim outcomes in two different workers' compensation programs. METHODS: Regression models were run for claim outcomes using data from two Canadian jurisdictions with different experience-rating programs-one with prospective (British Columbia) and another with retrospective (Ontario) adjustment of premiums. Key explanatory variables were past premium adjustments...
July 2016: Journal of Occupational and Environmental Medicine
Mathieu Chatelain, Guido H E Gendolla
Integrating the implicit-affect-primes-effort model (Gendolla, 2012, 2015) with the principles of motivational intensity theory (Brehm & Self, 1989) we investigated if the effort mobilization deficit observed in people exposed to fear primes (vs. anger primes) in a difficult short-term memory task could be compensated by high monetary incentive. Effort was operationalized as cardiac response. We expected that fear primes should lead to the strongest cardiac pre-ejection period (PEP) reactivity when incentive was high (high subjective demand and high justified effort) and to the weakest response when incentive was low (high subjective demand but only low justified effort)...
May 2016: Biological Psychology
Thomas G Peters, Jonathan S Fisher, Robert G Gish, Richard J Howard
IMPORTANCE: Patients in the United States waiting for kidney transplantation die in increasing numbers owing to the severe kidney shortage, which might be alleviated by compensating living kidney donors. OBJECTIVE: To determine the willingness of voting US citizens to become living kidney donors and to ascertain the potential influence of compensation for donation. DESIGN, SETTING, AND PARTICIPANTS: A professionally designed quantitative survey was administered by an international polling firm in June 2014...
August 1, 2016: JAMA Surgery
Bo Jiang, Lu Zhang, Zhi-yun Ouyang
Qinghai Lake is the largest inland and salt water lake in China, and provides important ecosystem services to beneficiaries. Economic valuation of wetland ecosystem services from Qinghai Lake can reveal the direct contribution of lake ecosystems to beneficiaries using economic data, which can advance the incorporation of wetland protection of Qinghai Lake into economic tradeoffs and decision analyses. In this paper, we established a final ecosystem services valuation system based on the underlying ecological mechanisms and regional socio-economic conditions...
October 2015: Ying Yong Sheng Tai Xue Bao, the Journal of Applied Ecology
Meghan Wong
No abstract text is available yet for this article.
January 2016: MGMA Connexion
Elham Mahmoudi, Lee Squitieri, Brianna L Maroukis, Kevin C Chung, Jennifer F Waljee
PURPOSE: To understand the differences in transfer incidence for patients with upper extremity trauma by hospital trauma center designation. We hypothesized that patients with public or no insurance were more likely to be transferred to another facility compared with privately insured patients. METHODS: Trauma centers are designated by local authorities and verified by the American College of Surgeons. Using the 2012 National Trauma Data Bank, we examined the probability of being transferred from one center to another for patients who sustained isolated upper extremity trauma...
April 2016: Journal of Hand Surgery
Zachary Corrigan, Walter Winslow, Charlie Miramonti, Tim Stephens
This article touches on the complex and decentralized network that is the US health care system and how important it is to include emergency management in this network. By aligning the overarching incentives of opposing health care organizations, emergency management can become resilient to up-and-coming changes in reimbursement, staffing, and network ownership. Coalitions must grasp the opportunity created by changes in value-based purchasing and impending Centers for Medicare and Medicaid Services emergency management rules to engage payers, physicians, and executives...
February 2016: Disaster Medicine and Public Health Preparedness
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