Summary: Paying For Care
An interesting aspect of the entire environment regarding how providers are compensated is provided by the RAND Corporation. The article highlights the transformation and the models that have been structured within the health care industry, the article is appropriately titled: Paying for Care: In Depth.
I will offer two key observations: “In 2016, 85% of Medicare fee-for-service payments will be tied to quality or value through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs; the target increases to 90% by 2018. In 2016, 30% of Medicare payments will be tied to quality or value through alternative payments models such as ACOs or bundled payment arrangements. That goal increases to 50% by
2018” (RAND Corporation, 1994 - 2016)
Seemingly the focus is once again shifting, while there was initial collaboration of various health care entities in linking incentives with performance standards, there has been contrasting opinions (based on data) if quality improvement has actually occurred. Again, pay-for-performance is only one of contrasting initiatives that formulated to stimulate improvements in quality of care. Depending on the areas that are being evaluated, or studied during the conduct of research, may directly have a bearing on the level of and at what pace the improvement is occurring.
Furthermore:
“A recent report by RAND reviewed 49 studies that examined the effect of pay-for-performance programs on process and outcome measures. Overall the results of the studies were mixed, and studies with stronger methodologies showed relatively small impacts on health outcomes” (Baird, 2016)
Apparently, there is wide spread opinion on the effectiveness of pay-for-performance measures, testing or the evaluation process to evaluate the level of quality, or quality improvement is measured by contrasting methodologies. This was highlighted by the previously mentioned observation by the RAND Corporation, stronger methodologies resulted in minor impacts on health outcomes.
Additionally, “The pay-for-performance model still leaves the fundamental fee-for-service system intact, and does not address the issue of fragmentation in care delivery” (Baird, 2016).
Summary: quality and cost containment are both directly linked, the system is fragmented, methodologies to measure quality vary, but the defining factor to consider is the human element. In order for improvement in any system, there has to be some level of alignment, maximum collaboration, and transparency between all of the parties involved in order to reach a desired and beneficial outcome.
I will offer two key observations: “In 2016, 85% of Medicare fee-for-service payments will be tied to quality or value through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs; the target increases to 90% by 2018. In 2016, 30% of Medicare payments will be tied to quality or value through alternative payments models such as ACOs or bundled payment arrangements. That goal increases to 50% by
2018” (RAND Corporation, 1994 - 2016)
Seemingly the focus is once again shifting, while there was initial collaboration of various health care entities in linking incentives with performance standards, there has been contrasting opinions (based on data) if quality improvement has actually occurred. Again, pay-for-performance is only one of contrasting initiatives that formulated to stimulate improvements in quality of care. Depending on the areas that are being evaluated, or studied during the conduct of research, may directly have a bearing on the level of and at what pace the improvement is occurring.
Furthermore:
“A recent report by RAND reviewed 49 studies that examined the effect of pay-for-performance programs on process and outcome measures. Overall the results of the studies were mixed, and studies with stronger methodologies showed relatively small impacts on health outcomes” (Baird, 2016)
Apparently, there is wide spread opinion on the effectiveness of pay-for-performance measures, testing or the evaluation process to evaluate the level of quality, or quality improvement is measured by contrasting methodologies. This was highlighted by the previously mentioned observation by the RAND Corporation, stronger methodologies resulted in minor impacts on health outcomes.
Additionally, “The pay-for-performance model still leaves the fundamental fee-for-service system intact, and does not address the issue of fragmentation in care delivery” (Baird, 2016).
Summary: quality and cost containment are both directly linked, the system is fragmented, methodologies to measure quality vary, but the defining factor to consider is the human element. In order for improvement in any system, there has to be some level of alignment, maximum collaboration, and transparency between all of the parties involved in order to reach a desired and beneficial outcome.