Reimbursement and Pay-for-Performance

Better Essays
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.

You May Also Find These Documents Helpful

  • Powerful Essays

    been a pervasive issue in health care because of the Pay-for-Performance (P4P) Programs. Pay-for-performance is defined as a plan of reimbursement that connects compensation to quality and effectiveness as a motivation to develop the health care quality as well as making a decrease in costs. Hospitals and providers are being encouraged by government agencies and individual health plans to encourage excellence standards. Pay-for-performance methods could cause consequences such as reduction admission…

    • 1475 Words
    • 6 Pages
    Powerful Essays
  • Powerful Essays

    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…

    • 1495 Words
    • 6 Pages
    Powerful Essays
  • Powerful Essays

    Reimbursement and Pay-for-Performance Paper Venturis Jones HCS/531 June 01, 2015 Dale Mueller Reimbursement and Pay-for-Performance Paper Pay-for-Performance healthcare definition fluctuates. Pay-for-Performance is explained as an equivalent based procuring strategy with the initiative to link reimbursement to quality and efficiency as an incentive to improve health care, as well as reduce costs (Shi & Singh, 2012). Also considered a pay-for-performance financial plan that includes several forms…

    • 1525 Words
    • 5 Pages
    Powerful Essays
  • Powerful Essays

    Reimbursement and Pay-for-Performance Reimbursement and Pay-for-Performance are at the heart and soul of every health care organization. Without money coming in there is no way to pay for the services in which are offered to the individuals that need them. The individuals that need the services are required in one way or another to provide payment for these services. Individuals’ chose the health care coverage needed and than the insurance companies develop plans to fit needs to the people. The…

    • 1487 Words
    • 6 Pages
    Powerful Essays
  • Good Essays

    Pay for Performance

    • 1733 Words
    • 7 Pages

    Pay For Performance Jentry Pippin HCS/531 December 24, 2012 Jody Sklar Pay For Performance Prior to the 2000s, fee-for-service systems dominated how health…

    • 1733 Words
    • 7 Pages
    Good Essays
  • Better Essays

    Pay For Performance

    • 1640 Words
    • 7 Pages

    Reimbursement and Pay-for-Performance Candace Mills HCS/531 June 16, 2014 Mrs. Baptist Introduction As we come into the 21st Century, we find Healthcare is at a crisis level. Every agency is working on healthcare reform from policymakers to the public and private sector, as well as federally funded Medicare and Medicaid. The business of Medicine is greatly influenced by the government (federal, state and local levels) and private health sections that initiate policies. Pay for Performance…

    • 1640 Words
    • 7 Pages
    Better Essays
  • Powerful Essays

    Pay for Performance

    • 1117 Words
    • 5 Pages

    Pay-for-Performance Jamie D Knutter HCS/531: Health Care Organizations and Delivery Systems October 1st, 2012 Instructor: Doreen Gounaris Pay-for-Performance “Pay for performance has become a central strategy in the drive to improve health care” (Joynt, Jha, Orav, & Epstein, 2012, p. 1606). There are many aspects of pay-for-performance. These aspects include; effects of reimbursement by this approach,…

    • 1117 Words
    • 5 Pages
    Powerful Essays
  • Better Essays

    Pay for Performance

    • 2085 Words
    • 9 Pages

    Reimbursement and Pay-for-Performance HCS/531 March 25, 2013 Reimbursement and Pay-for-Performance With health care reform taking full effect, various changes are emerging with regard to health care provider reimbursements. Third-party and government payers are rapidly moving toward pay-for-performance approaches that emphasize the quality rather than the quantity of health care services. Pay-for-performance initiatives have the capability of significantly impacting reimbursements based…

    • 2085 Words
    • 9 Pages
    Better Essays
  • Better Essays

    Pay for Performance

    • 1852 Words
    • 8 Pages

    Pay for Performance Park University Overview Incentive pay, also known as "pay for performance" is generally given for specific performance results rather than simply for time worked. While incentives are not the answer to all personnel challenges, they can do much to increase worker performance. (Billikopf) Performance pay has various names: merit pay, pay for performance, knowledge-and-skill- based pay, or individual or group incentive pay. (Delisio) Pay for performance systems have…

    • 1852 Words
    • 8 Pages
    Better Essays
  • Better Essays

    Pay for Performance

    • 1342 Words
    • 5 Pages

    Running head: PAY FOR PERFORMANCE Pay For Performance Tais Dominguez 08 June 2014 HRMD 640 Turnitin: 30% The purpose of this paper is to prove that higher compensation yields higher performance and profitability. It’s important to begin this paper by stating that compensation is a very significant human resources tool that is used by organizations around the globe to manage their employees. For an organization to receive its money’s worth, and motivate…

    • 1342 Words
    • 5 Pages
    Better Essays