Posts Tagged “Pay For Performance”
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Pay for Performance in Lower Income Countries
by Kevin Roche on Tuesday, April 9, 2013
While we often focus our attention on the health care problems of the developed world, lower income countries have bigger issues, many of which are being addressed with the same “innovations” used in the richer nations. An NBER paper looks at the use of pay-for-performance in these countries.
2012 Potpourri XXXV
by Kevin Roche on Friday, November 16, 2012
Thanks be given for our last Potpourri before Thanksgiving, a table spread with delectable bites of information on hospital readmissions and quality measure performance, health plan enrollment growth, health price rises, use of deductibles in employer-based health insurance and trends in employment of physicians.
Tags: Consumers, Health Care Costs, Health Care Quality, Health Insurance, Hospital Readmissions, Medicare, Pay For Performance, Physicians
A Pay-for-Performance Program That May Have Worked
by Kevin Roche on Monday, November 12, 2012
Research reported in the New England Journal of Medicine suggests that a hospital pay-for-performance program in part of England may have led to reduced mortality for three conditions, with pneumonia showing a statistically significant decrease.
And One More Thing About Pay-for-Performance
by Kevin Roche on Thursday, October 25, 2012
In yet another piece evaluating the effectiveness to-date of pay-for-performance programs, Health Affairs carries a review of research on the topic, finding that results are mixed. Some seem to have improved quality, but others did not and providers caring for poorer and sicker patients may be disadvantaged.
Tags: Health Care Costs, Health Care Quality, Pay For Performance
Public Reporting of Outcomes Also Has Problems
by Kevin Roche on Tuesday, October 23, 2012
More research, this time from the Journal of the American Medical Association, to suggest that another quality improvement technique, this time public reporting of outcomes, does not achieve the intended goals. In regard to heart attack patients receiving PCI, public reporting seems to lead to lower rates of the procedure and no change in mortality outcomes.
Pay for Performance Has Problems
by Kevin Roche on Monday, October 22, 2012
Research reported in the New England Journal of Medicine reveals that the Centers for Medicare and Medicaid Services program of not paying for certain hospital acquired infections is not working, to put it mildly. The program seems to have had absolutely no impact on the targeted infection rates.
Tags: Health Care Quality, Hospital, Medicare, Pay For Performance
Financial Incentives for Providers
by Kevin Roche on Wednesday, August 29, 2012
Are financial incentives for providers a good thing? A review in the British Medical Journal examines when financial incentives can be helpful in improving care and when they might actually lead to worse outcomes. The authors created a checklist designed to provide easy guidance on design and implementation of pay for performance type programs.
2012 Potpourri XVI
by Kevin Roche on Saturday, May 5, 2012
This edition of our data-packed Potpourri focuses on hospital readmissions, use of computer physician order entry systems, what employers will do after 2014 when all of the health law kicks in, and hospital pay-for-performance programs.
Tags: Employers, Health Insurance, Health Insurance Exchange, HIT, Hospital, Hospital Readmissions, Pay For Performance
Regulatory Impediments to Pay-for-Performance
by Kevin Roche on Thursday, May 3, 2012
Pay-for-performance programs have enough problems demonstrating that they actually work to improve outcomes and now the Government Accounting Office has identified another potential problem for these initiatives–the federal fraud and abuse regulations.
Tags: Government, Pay For Performance, Regulation
2012 Potpourri XIII
by Kevin Roche on Friday, April 13, 2012
Our latest Potpourri features the comparative cost of cancer care in the US and elsewhere, the effect of genomics on spending, international practice guidelines, state Medicaid waivers, unintended consequences from patient satisfaction efforts and county health rankings.
Tags: Comparative Effectiveness, Consumers, Health Care Costs, Health Care Quality, Medicaid, Medical Care, Pay For Performance
Coding and Outcomes Measurements
by Kevin Roche on Wednesday, April 11, 2012
In an era of multiple programs measuring outcomes and costs by provider and by disease or condition, the importance of consistent coding in the data used to do the measurement cannot be overstated, yet it appears that coding, and coding changes may have a substantial influence in results, according to a new JAMA study.
Tags: Health Care Costs, Health Care Quality, Pay For Performance
Another Pay-for-Performance Bust
by Kevin Roche on Monday, April 2, 2012
Makes sense that paying for better delivery of quality care would improve outcomes, but the research so far doesn’t support that notion. The latest evidence is a study in the New England Journal of Medicine on the patient outcomes effects of the Medicare Hospital Quality Incentive Demonstration.
2012 Potpourri VIII
by Kevin Roche on Friday, March 2, 2012
Its March and spring nears; our Potpourri blooms with nuggets of health care information, including comparative regulation of medical devices in the US and Europe, do physicians always truthful with patients, CMS’ oversight of home health care agencies, the validity of a CMS’ measure of ER scanning, and patient-centered care.
Tags: Consumers, Devices, FDA, Health Care Quality, HomeCare, Medicare, Pay For Performance, Physicians
Patient Satisfaction and Quality
by Kevin Roche on Wednesday, February 15, 2012
Patient satisfaction surveys and scores are a large component in most pay-for-reporting, pay-for-performance and value-based purchasing programs, on the theory that patient satisfaction is linked to quality. A new study published in the Archives of Internal Medicine undercuts this theory.
Tags: Health Care Quality, Patient Satisfaction, Pay For Performance
CBO on Medicare’s Value-Based Payment Demos
by Kevin Roche on Thursday, February 2, 2012
Another excellent paper from the Congressional Budget Office is issued, this one on Medicare’s demonstration projects on value-based payments to providers. Once again, the demonstrations had very mixed results, with only one demonstration generating savings for the Medicare program.
Tags: Bundled Payments, Health Care Costs, Health Care Quality, Pay For Performance, Providers
Calculating Hospital Mortality Rates
by Kevin Roche on Tuesday, January 17, 2012
When money starts getting attached to calculations, the nitty-gritty of how the data for the calculations is collected and how the calculation is defined become very important. An article in the Annals of Internal Medicine examines methods for determining hospital mortality rates, finding differences across methods that could have important financial consequences.
Public Reporting of Performance Measures
by Kevin Roche on Thursday, January 5, 2012
The Agency for Healthcare Research and Quality examines the supposed mechanisms by which public reporting of provider performance on quality measures will improve outcomes and details the evidence which supports or fails to support that theory.
2011 Potpourri XXXXVIII
by Kevin Roche on Friday, December 16, 2011
The holiday season is in full swing, as is the time for bad weather, but nothing can deter the delivery of our Potpourri of health stories, including this week the nocebo effect, use of imaging when a financial interest in the equipment is present, broker commissions and the MLR, present-on-admission indicators, selecting patients for use in performance measuring, and physicians views of health insurers.
Tags: Health Care Costs, Health Care Quality, Health Insurance, Hospital, Medical Care, Pay For Performance, Physicians
Performance Measures
by Kevin Roche on Thursday, December 15, 2011
Health care is now full of all kinds of performance measures, and the results are increasingly used for payment-related purposes, raising their potential impact significantly. A new Rand report sponsored by the National Quality Forum examines the use of performance measures and evaluates their impact.
2011 Potpourri XXXXV
by Kevin Roche on Friday, November 18, 2011
No Potpourri next week due to the holiday, so enjoy this festive collection of health care nuggets, including pay-for-performance in large physician groups, employer views on the effect of the reform law, the effect of physician financial interest in cardiac testing, experience with high deductible plans, medical homes and quality improvement and for-profit and non-for-profit hospital treatment of the uninsured.
Tags: ACO, Care Management, Consumer Directed Health, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, Hospital, medical home, Pay For Performance, Physicians
2011 Potpourri XXXXIV
by Kevin Roche on Friday, November 11, 2011
The cold is approaching so curl up on the sofa and enjoy the warmth of our Potpourri, this week featuring results from a pay-for-performance program, the effect of the health insurance tax on premiums and employment, the evidence for a stroke treatment, collaborative care for heart disease and physicians views on their practices and health information tools.
Tags: Care Management, Consumers, Evidence-based care, Health Care Reform, Health Insurance, Medical Care, Pay For Performance, Physicians
AHRQ on Provider Performance Reporting
by Kevin Roche on Thursday, November 3, 2011
The world’s aflame with reporting on provider quality and cost performance. Making sure the information is complete, accurate and credible is no simple task, as a recent Agency for Healthcare Research and Quality report demonstrates.
Tags: Health Care Quality, Hospital, Pay For Performance, Physicians
2011 Potpourri XXXX
by Kevin Roche on Friday, October 14, 2011
The leaves fall but not the quality of our Potpourri, this week covering beneficiaries’ use of Medicare Star ratings, quality of care guidelines and older patients, compassionate care, asthma care guidelines and outcomes, infection control in hospitals and informal caregivers in California.
Tags: Consumer Directed Health, Elder Care, evidence based medicine, Health Care Costs, Health Care Quality, Hospital, Medicare, Pay For Performance
2011 Potpourri XXXVII
by Kevin Roche on Friday, September 23, 2011
Another wonderful collection of health care research summaries, including a GAO report on likely effects of the MLR rule, physician work intensity, reducing hospital-acquired infections, discharge followup and hospital readmissions, the effect of pay-for-performance on cardiac care and use of EHRs and health history recording.
Tags: EHRs, HAI, Health Care Reform, HIT, Hospital, MLR, Pay For Performance, Physicians, Readmissions
Review of Physician Financial Incentive Programs
by Kevin Roche on Wednesday, September 14, 2011
A new Cochrane Review finds very minimal evidence to suggest that efforts aimed at improving quality of care by creating financial rewards or penalties for primary care physicians are having the desired impact, suggesting caution in implementing the programs until there is further and better quality research.
Physician Pay-for-Performance Programs
by Kevin Roche on Tuesday, August 30, 2011
A paper from the National Bureau of Economic Research examines the effect of a physician pay-for-performance program in Canada. The study found very limited effects of the incentives in spurring greater delivery of the care which was incented.
2011 Potpourri XXVI
by Kevin Roche on Friday, July 1, 2011
Fireworks galore for the Fourth of July Potpourri, including dynamite excerpts on the effects of parent caregiving on caregivers’ financial status; health insurance exchanges; physician compensation; provider performance data gathering and use; hospital market concentration; use of HIT in nursing homes and teen use of health websites.
Tags: Consumers, Elder Care, Health Care Costs, Health Care Reform, Health Insurance, HIT, Hospital, Meaningful Use, Pay For Performance, Physicians, Telemedicine
Accurate Provider Performance Reporting
by Kevin Roche on Monday, June 20, 2011
Provider performance reporting is spreading rapidly and increasingly has payment consequences attached to it. New research published in JAMA gives further reason to be cautious in designing and implementing these programs.
2011 Potpourri XVII
by Kevin Roche on Friday, April 22, 2011
Happy Easter and welcome to our latest Potpourri, which will raise you up with information on workplace wellness, hospital pricing, clinical decision support systems, using HIT to save on drug development costs, CMS’ quality improvement programs and health care M&A activity.
Tags: Care Management, Drugs, Health Care Quality, HIT, Hospital, M&A, Pay For Performance, Workplace
Ensuring the Utility of Performance Measures
by Kevin Roche on Tuesday, April 19, 2011
Researchers examine what can be done to improve the science of performance measurement in a new Health Affairs article, making valuable suggestions to increase the credibility of an increasingly important aspect of our health system.
2011 Potpourri XVI
by Kevin Roche on Friday, April 15, 2011
Happy Easter and welcome to our spring kickoff potpourri, complete with a survey on technology use by consumers; brand drug pricing; how to get individuals to purchase health coverage; views of the Massachusetts reforms; hospital pay-for-performance and use of PHRs.
Tags: Consumers, Drugs, Health Care Reform, Health Insurance, HIT, Hospital, Pay For Performance
IOM on Trustworthy Evidence-Based Medicine
by Kevin Roche on Monday, March 28, 2011
The Institute of Medicine puts out two reports related to guidelines and the evidence supporting them which, if followed, should help ensure credible advances in scientific guidance for medical care.
Tags: Care Management, evidence based medicine, Pay For Performance
MedPAC Comments on Hospital Value Based Purchasing Rule
by Kevin Roche on Monday, March 21, 2011
The Medicare Payment Advisory Commission commented on the Medicare program’s proposed rule for a hospital value-based purchasing initiative, generally agreeing with CMS’ recommendations.
Tags: Hospital, Medicare, Pay For Performance
2011 Potpourri V
by Kevin Roche on Friday, January 28, 2011
On we go, wading through piles of research to arm you with the most relevant snatches of data, this week featuring geographic variation in the quality of drug prescribing; use of Facebook communities for health purposes; physicians’ hourly wages; medication adherence programs; surgical safety improvement; and using survey data to assess patient satisfaction.
Tags: Consumers, Drugs, Malpractice, Medical Care, Pay For Performance, Physicians, Telemedicine
Process of Care and Health Outcomes
by Kevin Roche on Wednesday, October 20, 2010
As the use of pay-for-reporting and pay-for-performance grows, there is more research into whether care processes being measured are really related to ultimate health outcomes. A new article says not necessarily.
Tags: Care Management, Health Care Quality, Hospital, Medicare, Pay For Performance
2010 Potpourri XXXV
by Kevin Roche on Saturday, September 25, 2010
The days are shortening and the light fades, but there is still enough to read our Potpourri, which this week includes two benefit consultants’ views on health care coverage costs for next year, hospice care at end-of-life, insurance premium hikes in Connecticut, Massachusetts health reform outcomes, and how patients’ characteristics affects doctors’ quality ratings.
Tags: Health Care Costs, Health Care Reform, HIT, Medical Care, Pay For Performance, Physicians, Workplace
2010 Potpourri XXXIV
by Kevin Roche on Saturday, September 18, 2010
On the menu for this week’s potpourri–savings from wellness efforts for a large employer; drug reimbursement for Medicaid programs; using remote monitoring in a health plan context; the FDA’s regulatory approach to mobile health uses; the effect of tort reform on imaging rates and hepatitis C pay-for-performance measures.
Tags: Disease Management, Drugs, FDA, Health Care Reform, Malpractice, Mobile, Monitoring, Pay For Performance, Wellness and Prevention, Wireless
2010 Potpourri XXXIII
by Kevin Roche on Saturday, September 11, 2010
Fall is a lovely time of year and what could be better than relaxing with a Potpourri, featuring health insurance increases, the true costs of EHRs, hospital pay-for-performance programs and quality, the impact of social networks on health behavior, and unenrolled Medicaid-eligible children.
Tags: Consumers, Government, Health Care Costs, Health Care Quality, HIT, Hospital, Medicaid, Pay For Performance, Workplace
2010 Potpourri XXVII
by Kevin Roche on Saturday, July 31, 2010
A lot of great items in this week’s potpourri, covering the acquisition of HealthGrades, what encourages men to get screenings, potential cheating on pay-for-performance schemes, the problems of a multi-payer system, improving heart failure care, Canada’s experience with EHRs and autonomous robot surgery.
Tags: HIT, M&A, Medicaid, Medical Care, Pay For Performance, Payor, Wellness and Prevention
Hospital Pay-for-Performance Programs
by Kevin Roche on Tuesday, July 6, 2010
Medicare has an impending value-based purchasing program for hospitals. Payments would be based on performance against quality standards. Some hospitals ability to improve performance may be limited by the economic and workforce characteristics of their location, according to new research.
Tags: Hospital, Medicare, Pay For Performance
Pay-for-Performance Program Evaluation
by Kevin Roche on Monday, March 8, 2010
Three recent articles provide some additional insight into pay-for-performance programs. Research has generally shown inconsistent results, so there is great benefit in understanding what features may make a program most successful in improving quality and outcomes.
Tags: Pay For Performance, Physicians
2010 Potpourri V
by Kevin Roche on Saturday, February 13, 2010
One more Saturday….morning. And another potpourri of health care news. This one includes health information technology, consumer directed health plans, guidelines, support group functioning, end-of-life care and telemedicine.
Tags: Consumer Directed Health, Consumers, End-of-Life Care, HIT, Pay For Performance, Telemedicine
Quality Reporting Programs Impose Costs on Physician Practices
by Kevin Roche on Monday, January 25, 2010
Quality measurement and pay-for-performance programs continue to spread, in the belief that they will improve health care quality. A new study looks at the costs these programs impose on physician practices, finding that any financial incentives are usually lower than the costs.
Tags: Health Care Reform, HIT, Pay For Performance, Physicians
Weekend Potpourri VIII
by Kevin Roche on Saturday, December 19, 2009
More health care snippets, including hospital costs, wireless health in 2009, genetic testing, caring for the elderly and pay-for-performance programs. Bon Apetit!
Tags: Care Management, Pay For Performance, Personalized Medicine, Wireless
Potpourri VII
by Kevin Roche on Saturday, December 12, 2009
Mercer surveyed employers to ascertain their reaction to the proposed tax on high value insurance coverage. The majority said they would reduce benefits to avoid the tax. Seven percent said they would outright terminate insurance coverage. Of those saying they would reduce benefits, most would do so by raising deductibles and copays. Employers also narrowly [...]
Tags: Drugs, Health Care Reform, Health Insurance, Medical Care, Pay For Performance, Telemedicine
Report Cards Get a Failing Grade
by Kevin Roche on Wednesday, December 9, 2009
A study suggests that hospital report cards on cardiac care in Canada did not result in significant performance improvement. Even less clear is whether they lead to better health outcomes.
Tags: Hospital, Pay For Performance
Weekend Potpourri IV
by Kevin Roche on Saturday, November 14, 2009
Another dose of weekend tidbits, covering PAP screenings, health insurer consolidation, Part D plan satisfaction, Rand’s look at the best methods to reduce health care costs, geographic variations in health spending and coughing into cell phones–yes you heard me right.
Tags: Drugs, Guidelines, Health Insurance, Medical Care, Medicare, Pay For Performance
California Pay for Performance Results
by Kevin Roche on Wednesday, September 9, 2009
The Integrated Healthcare Association has released its latest report on California’s physician pay for performance system.
Tags: Pay For Performance, Providers
An Interesting Pay-for-Performance Evaluation
by Kevin Roche on Friday, July 24, 2009
An analysis of England’s pay-for-performance system finds improvement but some interesting trends and concerns as well.
Tags: Health Care Reform, Medical Care, Pay For Performance, Physicians
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