Australian Healthcare
More often than any time before, healthcare budget is top of the political and media agenda in many countries around the world. The debate about the reform on healthcare payment model has frequently become the focus while the voice of supporting the shift from the current volume-based payment or soon to be activity-based payment to the ultimate outcome-based payment is getting louder over time. As a result, many authorities have linked the remuneration prob¬lem with concerns about quality and performance, focusing new attention on Payment for Performance (P4P) programmes. Under these programmes a portion of payment is dependent on performance assessed against one or more defined measures. The United States has over 100 private and federal Medicare reward and incentive programs (1), and Italy and New Zealand are beginning to reward performance in primary care.
This report seeks to present the cases for and against the proposal of adopting P4P by governments and insurers.
First and foremost, payers, both public and private are under tremendous pressure to curb cost while enhancing or at least maintaining quality, safety and access; and reduce variation in healthcare. For those who support the P4P programs, the idea of P4P is simple – rather than pay providers based on volume of patients or services, tie their payment to a measure(s) of performance. They argue that measuring the performance of physicians and provider on their quality and cost is fundamental to any effective reform and it is vitally important to signal to providers what patients and payer expect them to be working towards, and explicit measures – when tired to payment – help focus and redirect physicians and providers towards redesigning care processes and how they coordinate actions.
In addition, emerging theories (economic, organisational behaviour and psychology) and practical evidence, both suggest that P4P can change providers’ behaviour. Early report from the UK Quality Outcomes
This report seeks to present the cases for and against the proposal of adopting P4P by governments and insurers.
First and foremost, payers, both public and private are under tremendous pressure to curb cost while enhancing or at least maintaining quality, safety and access; and reduce variation in healthcare. For those who support the P4P programs, the idea of P4P is simple – rather than pay providers based on volume of patients or services, tie their payment to a measure(s) of performance. They argue that measuring the performance of physicians and provider on their quality and cost is fundamental to any effective reform and it is vitally important to signal to providers what patients and payer expect them to be working towards, and explicit measures – when tired to payment – help focus and redirect physicians and providers towards redesigning care processes and how they coordinate actions.
In addition, emerging theories (economic, organisational behaviour and psychology) and practical evidence, both suggest that P4P can change providers’ behaviour. Early report from the UK Quality Outcomes