Pay-For-Performance: Reimbursement System

Pay-For-Performance is a health care payment system developed to try and address the shortfalls of the current reimbursement payment system. Incentives are paid to hospitals, physicians, and clinics for the improved quality of care for patients, efficiency of care, and improved health outcomes of patients. Pay-For-Performance is part of the improvement of quality as well as a cost management tool. Currently the reimbursement system that is in place pays for services rendered prompting providers to order tests or services that may not be necessary but offer them a better reimbursement. Pay-For-Performance will pay for the improved treatment and health of a patient, so instead of just ordering a bunch of services providers will focus more on
However the extra attention to detail of a patients life and health habits may reduce the amount of patients each provider can services, having to focus more time on each patient for higher quality of care makes it very difficult to keep the quantity of patients. Usually the fewer patients a provider has is helpful and allows the provider to provide better quality of care, however there are not enough current providers to service the number of patients in the United States. Providers are left with the struggle of balancing the number of patients they can service with the quality of care they can provide. While the idea of Pay-For-Performance systems is good there are concerns about the future effects on the health care system. One concern is that providers will pick and choose their patients by their health history leaving the sickest without care. The Pay-For-Performance system focuses on the outcomes of patients treatments as well as the manner in which they are treated. Because it is easier to have healthy patients if you start with patients that are not that sick in the first place it is a concern that providers will only take on patients that have simple or no health
Many seniors rely on their provider to on top of their health for them since many of them have a hard time keeping track of their conditions, treatments, and medications on their own. It seams to me that Pay-For-Service systems are a start in the right direction but it is more likely that a system that has both elements of Fee-For-Service and Pay-For-Performance would be a good balance. Both incentive systems have their flaws and bring up concerns, but the two together with some tweaking there and there might be a better solution. Unfortunately there will never be a perfect health care system it is just to complex to be able to work out every solution to every possible issue. Even though there will never be a perfect solution to our health care system I believe we could come close some day. We need to look at what has worked and what has not worked and build off that keeping the politics out of it and focus on what is best for the patients and the providers, not the insurance companies or the government. Referneces Baker, G. (2003). Pay for Performance Incentive Programs in Healthcare.Market Dynamics and Business Process,(), 3. Blum, E. (2006,November). Is pay-for-performance a viable way to improve patient care and safety.American