Individual Reimbursement And Pay-Performance

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Individual Reimbursement and Pay-for-Performance Paper HCS 531 Individual Reimbursement and Pay-for-Performance Paper Reimbursement is affected by the pay-for-performance approach in many ways.It is very hard to define quality in primary care. The health care providers come to the health care industry with different variations in practice, training levels and experiences, socio-demographics, geography as well as external factors. These various issues make it hard to measure if the health care provider is giving the quality service that the entity paying want them to perform. Entities that are paying for care want to measure the services they are paying for are of high quality and if the care can be performed at a lower cost. According…show more content…
According to Rosenau, Lai, and Lako (2012), the United States health care industry P4P is one of the most important developments after capitation and managed care. The target of P4P is to change the behavior patients, physicians, and those working in the health care industry through a system of rewards and punishments. The P4P bonus for physicians can become the form of an add-on to his or her salary to the general fee-for-service. A bonus for a hospital can be additional payments beyond the payments received through the diagnosis group based payment. A punishment through the P4P system can end in the reduction of compensation or other penalties. These forms of incentives or punishments are important to the health care since the entity relies on the financial disbursement for the services provided. The health care entities can do beyond the projected financial goal or can sink lower than the projected goal. The organization can thrive or it can go under as a result of the P4P…show more content…
P4P programs are here to stay. These programs are pushed by private insurers and the Federal Government. According to,“SHAPING THE FUTURE OF PAY-FOR-PERFORMANCE PROGRAMS” (2005) it is critical to have the medical profession involved in the planning of the incentives for P4P programs isdeveloped. They will need to be more involved in the discussions with the insurers and employers about the P4P programs. P4P programs are the directions the health care industry is going and improvement to make the P4P programs work for the best outcome is critical. The P4P programs are designed to make improvements to the health care industry and measure the quality of caregiven. A system that does not work the way it is supposed to is useless. Mechanisms and entities needs to be in place to make sure the system is working correctly and is an asset to the health care industry. The United States is making huge changes in the health care industry. The health care reform can improve the health care industry and lower the cost of health care if policies are developed with health care experts. There are many countries that have mechanisms in place that have lower the health care and improved the quality of their health care system. The United States is a leader in many areas and should be able to figure out a health care system with the P4P

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