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"Pay for performance"

C Jason Wang, Skye H Cheng, Jen-You Wu, Yi-Ping Lin, Wen-Hsin Kao, Chia-Li Lin, Yin-Jou Chen, Shu-Ling Tsai, Feng-Yu Kao, Andrew T Huang
Importance: Value-driven payment system reform is a potential tool for aligning economic incentives with the improvement of quality and efficiency of health care and containment of cost. Such a payment system has not been researched satisfactorily in full-cycle cancer care. Objective: To examine the association of outcomes and medical expenditures with a bundled-payment pay-for-performance program for breast cancer in Taiwan compared with a fee-for-service (FFS) program...
October 20, 2016: JAMA Oncology
Armando H Norman, Andrew J Russell, Claudia Merli
The UK's Quality and Outcomes Framework (QOF) is the largest pay-for-performance scheme in the world. This ethnographic study explored how QOF's monetary logic influences the approach to healthcare in UK general practice. From August 2013 to April 2014, we researched two UK general practice surgeries and one general practice training programme. These environments provided the opportunity for studying various spaces such as QOF meetings, consultation rooms, QOF recoding sessions, and the collection of computer-screen images depicting how patients' biomarkers are evaluated and costed through software systems...
October 11, 2016: Social Science & Medicine
Constance E McIntosh, Cynthia M Thomas, Debra Siela
With recommendations from national nursing associations and accrediting bodies to transition to an all baccalaureate prepared nurse workforce by 2020, it is important to understand the expertise that a baccalaureate degreed nurse brings to patient care. The purpose of this article is to establish the differences of a non-bachelor of science in nursing (BSN) registered nurse and a 4-year prepared nurse, as well as to identify the education and clinical trends in critical care that require a BSN-prepared nurse...
November 2016: Dimensions of Critical Care Nursing: DCCN
Ricarda Milstein, Jonas Schreyoegg
Across the member countries of the Organisation for Economic Co-operation and Development (OECD), pay-for-performance (P4P) programs have been implemented in the inpatient sector to improve the quality of care provided by hospitals. This paper provides an overview of 34 existing P4P programs in the inpatient sector in 14 OECD countries based on a structured literature search in five databases to identify relevant sources in Danish, English, French, German, Hebrew, Italian, Japanese, Korean, Norwegian, Spanish, Swedish and Turkish...
September 20, 2016: Health Policy
Zarnie Khadjesari, Sarah L Hardoon, Irene Petersen, Fiona L Hamilton, Irwin Nazareth
AIMS: Lack of financial incentive is a frequently cited barrier to alcohol screening in primary care. The Quality and Outcomes Framework (QOF) pay for performance scheme has reimbursed UK primary care practices for alcohol screening in people with schizophrenia since April 2011. This study aimed to determine the impact of financial incentives on alcohol screening by comparing rates of alcohol recording in people with versus those without schizophrenia between 2000 and 2013. METHODS: Cross-sectional and retrospective cohort study...
October 13, 2016: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
Wenjing Tao, Janne Agerholm, Bo Burström
BACKGROUND: Reimbursement systems provide incentives to health care providers and may drive physician behaviour. This review assesses the impact of reimbursement system on socioeconomic and racial inequalities in access, utilization and quality of primary care. METHODS: A systematic search was performed in Web of Science and PubMed for English language studies published between 1980 and 2013, supplemented by reference tracking. Articles were selected based on inclusion criteria, and data extraction and critical appraisal were performed by two authors independently...
October 4, 2016: BMC Health Services Research
Laurent G Glance, Yue Li, Andrew W Dick
BACKGROUND: The validity of basing healthcare reimbursement policy on pay-for-performance is grounded in the accuracy of performance measurement. METHODS: Monte Carlo simulation was used to examine the accuracy of performance profiling as a function of statistical methodology, case volume, and the extent to which hospital or physician performance deviates from the average. RESULTS: There is extensive variation in the true-positive rate and false discovery rate as a function of model specification, hospital quality, and hospital case volume...
September 23, 2016: Anesthesiology
Cynthia L Gong, Joel W Hay, Daniella Meeker, Jason N Doctor
OBJECTIVE: To elicit prescribers' preferences for behavioural economics interventions designed to reduce inappropriate antibiotic prescribing, and compare these to actual behaviour. DESIGN: Discrete choice experiment (DCE). SETTING: 47 primary care centres in Boston and Los Angeles. PARTICIPANTS: 234 primary care providers, with an average 20 years of practice. MAIN OUTCOMES AND MEASURES: Results of a behavioural economic intervention trial were compared to prescribers' stated preferences for the same interventions relative to monetary and time rewards for improved prescribing outcomes...
2016: BMJ Open
Thomas Mason, Yiu-Shing Lau, Matthew Sutton
BACKGROUND: The limited number of existing previous studies of the distribution of quality under NHS Pay-for-performance (P4P) by income deprivation have not analysed the relationship at the individual level and have been restricted to assessing P4P in the primary care setting. In this study, we set out to examine how achievement of P4P 'quality measures' for which NHS hospitals were paid was distributed by income deprivation. METHODS: Design: Retrospective analysis of performance data reported by hospitals, examining how the probability of receiving 23 indicators varied by patients' area deprivation using logistic regression controlling for age and gender...
2016: International Journal for Equity in Health
Yewande Kofoworola Ogundeji, John Martin Bland, Trevor Andrew Sheldon
BACKGROUND: Pay for performance (P4P) incentive schemes are increasingly used world-wide to improve health system performance but results of evaluations vary considerably. A systematic analysis of this variation in the effects of P4P schemes is needed. METHODS: Evaluations of P4P schemes from any country were identified by searching for and updating systematic reviews of P4P schemes in health care in four bibliographic databases. Outcomes using different measures of effect were converted into standardized effect sizes and each study was categorized as to whether or not it found a positive effect...
September 5, 2016: Health Policy
Mehdi Ammi, Christine Peyron
Despite increasing popularity, quality improvement programs (QIP) have had modest and variable impacts on enhancing the quality of physician practice. We investigate the heterogeneity of physicians' preferences as a potential explanation of these mixed results in France, where the national voluntary QIP - the CAPI - has been cancelled due to its unpopularity. We rely on a discrete choice experiment to elicit heterogeneity in physicians' preferences for the financial and non-financial components of QIP. Using mixed and latent class logit models, results show that the two models should be used in concert to shed light on different aspects of the heterogeneity in preferences...
December 2016: Health Economics Review
Stephen Barlas
Escalating drug prices have seeded interest in value-based purchasing, but confusion and controversy have slowed the Centers for Medicare and Medicaid Services, state agencies, and private insurers from pursuing the potential savings.
September 2016: P & T: a Peer-reviewed Journal for Formulary Management
Sanjay Basu, Russell S Phillips, Zirui Song, Bruce E Landon, Asaf Bitton
PURPOSE: We assess the financial implications for primary care practices of participating in patient-centered medical home (PCMH) funding initiatives. METHODS: We estimated practices' changes in net revenue under 3 PCMH funding initiatives: increased fee-for-service (FFS) payments, traditional FFS with additional per-member-per-month (PMPM) payments, or traditional FFS with PMPM and pay-for-performance (P4P) payments. Net revenue estimates were based on a validated microsimulation model utilizing national practice surveys...
September 2016: Annals of Family Medicine
Daniel H Jung, Mari Palta, Maureen Smith, Thomas R Oliver, Eva H DuGoff
INTRODUCTION: In 2012, the Centers for Medicare and Medicaid Services (CMS) introduced the Quality Bonus Payment Demonstration, a pay-for-performance (P4P) program, into Medicare Advantage plans. Previous studies documented racial/ethnic disparities in receipt of care among participants in these plans. The objective of this study was to determine whether P4P incentives have affected these disparities in Medicare Advantage plans. METHODS: We studied 411 Medicare Advantage health plans that participated in the Medicare Health Outcome Survey in 2010 and 2013...
September 8, 2016: Preventing Chronic Disease
Ciara Pendrith, Amardeep Thind, Gregory S Zaric, Sisira Sarma
OBJECTIVES: The primary objective of this paper is to compare cervical cancer screening rates of family physicians in Ontario's two dominant reformed practice models, Family Health Group (FHG) and Family Health Organization (FHO), and traditional fee-for-service (FFS) model. Both reformed models formally enrol patients and offer extensive pay-for-performance incentives; however, they differ by remuneration for core services (FHG is FFS; FHO is capitated). The secondary objective is to estimate the average and marginal costs of screening in each model...
August 2016: Healthcare Policy, Politiques de Santé
Camille Haycock, Michelle L Edwards, Christopher S Stanley
The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule that details a consolidated pay-for-performance provider payment system within the Medicare Access and CHIP Reauthorization Act. This proposed rule establishes policy for the new provider Merit-Based Incentive System and Alternative Payment Models. While the rule is extremely complex, and not yet finalized, there are significant implications for nursing and advanced practice providers. This proposed rule intends to drastically change the current provider payment system and reward providers who demonstrate better quality outcomes at a lower cost...
October 2016: Nursing Administration Quarterly
Peggy Richter, Martin Burwitz, Werner Esswein
Health care systems need to cope with continuous changes such as with the current trends towards pay-for-performance and value-based health care. In this context, the article aims at analysing the potentials of the integration and utilisation of quality indicators in clinical pathways. It comprises the first steps of a design-oriented research process, i.e. problem motivation and objective definition. Therefore, a conceptual framework for pathway-integrated quality indicators is proposed. Potentials of the approach are outlined in three use case scenarios...
2016: Studies in Health Technology and Informatics
Thomas P Huber, Stephen M Shortell, Hector P Rodriguez
OBJECTIVE: Examine the extent to which physician organization participation in an accountable care organization (ACO) and electronic health record (EHR) functionality are associated with greater adoption of care transition management (CTM) processes. DATA SOURCES/STUDY SETTING: A total of 1,398 physician organizations from the third National Study of Physician Organization survey (NSPO3), a nationally representative sample of medical practices in the United States (January 2012-May 2013)...
August 22, 2016: Health Services Research
Yu-Chin Huang, Miaw-Chwen Lee, Yiing-Jenq Chou, Nicole Huang
BACKGROUND: Several studies have investigated the effects of pay-for-performance (P4P) initiatives. However, little is known about whether patients with multiple chronic conditions (MCC) would benefit from P4P initiatives similarly to patients without MCC. OBJECTIVES: The objective of this study was to compare the effects of the diabetes mellitus pay-for-performance (DM-P4P) program on the quality of diabetic care between type 2 diabetic patients with and without MCC...
November 2016: Medical Care
Huei-Ju Chen, Nicole Huang, Long-Sheng Chen, Yiing-Jenq Chou, Chung-Pin Li, Chen-Yi Wu, Yu-Chia Chang
BACKGROUND: Many people are concerned about that the quality of preventive care for patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection is suboptimal. Taiwan, a hyperendemic area of chronic HBV and HCV infection, implemented a nationwide pay-for-performance (P4P) program in 2010, which aimed to improve the preventive care provided to HBV and HCV patients by increasing physicians' adherence to guidelines through financial incentives. The objective of this study was to evaluate the early effects of the P4P program on utilization of preventive services by HBV and HCV patients...
2016: PloS One
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