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Reimbursement and Pay-for-Performance

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Reimbursement and Pay-for-Performance
Reimbursement and Pay-for-Performance

HCS 531
November 11th, 2013
Regina Pointer
Introduction
There is a growing trend in the United States called pay-for-performance. Pay-for-performance is a system that is used where providers are compensated by payers for meeting certain pre-established measures for quality and efficiency (What is Pay-for-Performance, n.a.). We are going to be discussing what pay-for-performance is. There are different aspects of pay-for-performance which include; the effects of reimbursement by this approach, the impact cost reductions has on quality and efficiency of health care, the affects to the providers and patients, and the effects on the future of health care.
Pay-for-Performance
Pay-for-performance (P4P) and value-based purchasing are terms that can be heard within the health care industry which, describes payment systems that reward physicians, hospitals, and other health care providers for their quality and efficiency. The objective of pay-for-performance (P4P) initiatives is to link reimbursement to quality of health care as well as reduce systemwide costs (Shi & Singh, 2012). Government agencies as well as private health plans are in the process of establishing programs in hopes to encourage hospitals, doctors, and other providers so that they will start to meet the quality of standards and achieve the ideal outcome for patients. The overall goal for pay-for-performance is to increase the quality of health care, while reducing the medical costs by implementing programs that will focus on things such as preventative care which would include services such as annual exams and vaccinations.
Measurements and Incentives
When it comes to quality of care measurements there are different categories one of which being structure. The structure measures patients access to health care, the use of electronic systems and the patients experience of the care that they received. Incentives can be either financial incentives or


References: Agency for Healthcare Research and Quality (n.d.)   http://www.ahrq.gov/research/findings/factsheets/costs/costria/index.html Rosenthal, M.B. (2006). How Will Paying for Performance Affect Patient Care?. Retrieved from http://virtualmentor.ama-assn.org/2006/03/pfor1-0603.html Shi, L., & Singh, D. A. (2012). Delivering health care in America: Health Policy (5th ed.). Boston, MA: Jones and Bartlett. Retrieved from The University of Phoenix eBook Collection database.
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