Should Doctors Get Paid by Quality Care Incentives

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Should providers be paid for the quality of care they provide?  How might this be accomplished?  How might opinions vary between patients, payers, and providers on this issue - do you think their opinions will be different from each other? Explain your conclusions. There has been an equally longstanding interest in how the cost of health services to consumers affects the services they seek out and use, along with the implications of this for overall costs at various levels of aggregation. But there has been much less attention devoted by researchers to the impact of financial incentives on the quality of care. The Institute of Medicine in the USA has defined quality of care as ‘the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge".

This study reviews the healthcare literature that examines the effect of financial incentives
on the behavior of healthcare organizations and individuals with respect to the quality of
care they deliver to consumers. Its purpose is to provide guidance to policy-makers in
government and decision-makers in the private sector in their efforts to improve quality of
care through payment reforms. In this review and synthesis we assess the quality of the
evidence relating to the relationship between financial incentives for providers and quality
improvement. The findings from studies on the effect of payer initiatives that
reward providers for quality improvements or the attainment of quality benchmarks are
mixed. Relatively few significant impacts are reported, and it is often the case that payer
programmes include quality improvement components in addition to incentive payments,
making it difficult to assess the independent effect of the financial incentives. *
Very little research has been done on the impact of direct payments to hospitals to improve
quality. The...
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