Reimbursement And Pay-Performance In Health Care

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Reimbursement and Pay-for Performance 7/7/2014 HCS/531 Katherine Brewster Pay-for-performance is defined as an umbrella term for initiatives aimed at improving the quality, efficiency, and overall value of health care. These arrangements provide financial incentives to hospitals, physicians, and other health care providers to carry out such improvements and achieve optimal outcomes for patients ("Health Policy Briefs", 2012). Pay-for-performance has become popular among policy makers and private and public payers, including Medicare and Medicaid. The Affordable Care Act expands the use of pay-for-performance approaches in Medicare in particular and encourages experimentation to identify designs and programs that are most effective ("Health…show more content…
Now that there is sufficient data to convince most people (including Congress and major purchasers of health benefits) that there is a quality problem in the US health care system, it will be hard to resist the widespread urge to use that same information to reform an obviously imperfect payment system. Used effectively, pay-for-performance could remove some of the well-known distortions that are generated by the underlying structure of current payment systems and help refocus delivery on critical aspects of population health. If it is to succeed in promoting patient health and value for the health care dollar, pay-for-performance will require careful design and effective safeguards against potential unintended consequences including those associated with patient selection incentives (and the associated fairness concerns) and “teaching to the test” to ensure that these positive objectives are not achieved at too great a cost (Rosenthal,…show more content…
(2012). Retrieved from http://www.commonwealthfund.org/publications/international- innovation/apr/incentivizing-quality-care-through-pay-for-performance How will pay for performance ultimaley impact quality of care. (2013). Retrieved from http://www.kevinmd.com/blog/2013/01/pay-performance-ultimately-impact-quality- care.html National Institutes of Health. (2013). Retrieved from http://www.nih.gov/researchmatters/september2013/09232013performance.htm Pay-for-performance, data reporting may disadvantage high-risk patients. (2012). Retrieved from http://ehrintelligence.com/2012/11/29/pay-for-performance-data- reporting-may-disadvantage-high-risk-patients/ Reducing Costs in the Health Care System: Learning From What Has Been . (2002). Retrieved from http://www.ahrq.gov/research/findings/factsheets/costs/costria/index.html Simone, J. (2005, September ). Pay-for-Perfornance. Oncology Times, 27(17),

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