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Health Care Pay for Performance

"Pay for performance" rewards doctors, hospitals, and other health care providers for attaining targeted service goals, like meeting health care quality or efficiency standards. RAND research has explored a range of policy and economic implications related to the use of pay-for-performance delivery models.

Journal Article
Evaluation of the Million Hearts® Cardiovascular Disease Risk Reduction Model: Fourth Annual Report
In this model, CMS pays participating organizations for assessing each of their eligible Medicare beneficiary's risk of having a heart attack or stroke over the next 10 years and for reducing CVD risk among high-risk beneficiaries.
Oct 25, 2022
Journal Article
Evaluation of the Million Hearts® Cardiovascular Disease Risk Reduction Model: Third Annual Report
In its first three years, the Million Hearts® Model improved cardiovascular preventive care, but did not yet reduce observed heart attacks and strokes or lower Medicare spending.
Oct 25, 2022
Journal Article
Predicting Race And Ethnicity To Ensure Equitable Algorithms For Health Care Decision Making
We describe two applications in which imputation of race and ethnicity can help mitigate potential algorithmic biases: equitable disease screening algorithms using machine learning and equitable pay-for-performance incentives.
Aug 23, 2022
Report
RAND Technical Expert Panel Medicare Advantage (MA) and Part D Contract Star Ratings, February 7, 2022 Meeting
On February 7, 2022, the RAND Corporation convened a Technical Expert Panel web meeting to gather input about the potential development of a measure to capture value-based care arrangements Medicare Advantage organizations have with their contracted providers.
Jun 17, 2022
Journal Article
Physician Compensation Arrangements and Financial Performance Incentives in US Health Systems
This study was a cross-sectional mixed-methods analysis of in-depth multimodal data from 31 POs affiliated with 22 purposefully selected health systems in 4 states. Data were analyzed from June 2019 to September 2020.
Feb 8, 2022
Report
RAND Technical Expert Panel Medicare Advantage (MA) and Part D Contract Star Ratings, May 5, 2021 Meeting
The RAND team gathered input from experts about stratified reporting by Part D low-income subsidy (LIS) and dual eligibility (DE), and disability and assessing social risk factors of Medicare Advantage (MA) and Part D contract beneficiaries.
Aug 5, 2021
Journal Article
Developing Health Equity Measures
This work identified existing approaches to health equity measurement and evaluated those approaches using input from an expert panel.
May 21, 2021
Report
RAND Technical Expert Panel Medicare Advantage (MA) and Part D Contract Star Ratings, November 12, 2020 Meeting
On November 12, 2020, the RAND Corporation convened a Technical Expert Panel (TEP) web meeting to gather input about social risk factors and approaches for ensuring accurate performance measurement.
Mar 16, 2021
Report
RAND Technical Expert Panel Medicare Advantage (MA) and Part D Contract Star Ratings, November 19, 2020 Meeting
On November 19, 2020, the RAND Corporation convened a Technical Expert Panel (TEP) web meeting to gather input about stratified reporting of performance and approaches to reduce disparities in Medicare Advantage (MA) and Part D Contracts.
Mar 16, 2021
Journal Article
Quality of Quality Measurement: Impact of Risk Adjustment, Hospital Volume, and Hospital Performance
Monte Carlo simulation was used to examine the accuracy of performance profiling as a function of statistical methodology, case volume, and the extent to which hospital or physician performance deviates from the average.
Dec 31, 2020
Journal Article
Feasibility of Report Cards for Measuring Anesthesiologist Quality for Cardiac Surgery
We conducted a study of 55,436 patients undergoing cardiac surgery between 2009 and 2012. Hierarchical logistic regression modeling was used to examine the variation in in-hospital mortality or major complications.
Dec 30, 2020
Report
RAND Technical Expert Panel Medicare Advantage (MA) and Part D Contract Star Ratings, July 22, 2020 Meeting
On July 22, 2020, the RAND Corporation convened a Technical Expert Panel (TEP) web meeting to gather input on analyses that could be conducted to further enhance the Medicare Advantage (MA) and Part D Contract Star Ratings program.
Dec 23, 2020
Journal Article
Anesthesiologists and the Transformation of the Healthcare System: A Call to Action
This is the second in a series of six editorials on the changing definitions of safety across the perioperative period and how anesthesiologists can participate in and lead the transformation of health care with focus on patient value.
Dec 18, 2020
Report
RAND Medicare Advantage (MA) and Part D Contract Star Ratings Technical Expert Panel November 7th, 2019 Meeting
On November 7, 2019, the RAND Corporation convened a Technical Expert Panel (TEP) web meeting to gather input on analyses that could be conducted to further enhance the Medicare Advantage (MA) and Part D Contract Star Ratings program.
Feb 7, 2020
Report
RAND Medicare Advantage (MA) and Part D Contract Star Ratings Technical Expert Panel April 30, 2019 Meeting
On April 30, 2019, the RAND Corporation convened a Technical Expert Panel (TEP) web meeting to gather input on analyses that could be conducted to further enhance the Medicare Advantage (MA) and Part D Contract Star Ratings program.
Sep 6, 2019
Periodical
RAND Review: May-June 2019
This issue describes RAND research efforts to help schoolkids suffering from trauma; to help health care providers get better, more meaningful feedback; and to use technology to improve the lives of displaced people throughout the world.
Apr 29, 2019
Report
Rural Physicians' Perspectives on the Medicare Quality Payment Program
The Centers for Medicare & Medicaid Services recently launched its Quality Payment Program (QPP), which changes how physicians are paid under Medicare. Researchers interviewed rural physicians to determine if their practices could successfully participate and how the program could be modified to support small rural practices.
Mar 5, 2019
Report
RAND Medicare Advantage (MA) and Part D Contract Star Ratings Technical Expert Panel October 30th 2018 Meeting
On October 30, 2018, the RAND Corporation convened a Technical Expert Panel (TEP) web meeting to gather input on analyses that could be conducted to further enhance the Medicare Advantage (MA) and Part D Contract Star Ratings program.
Jan 18, 2019
Research Brief
The Effects of Alternative Payment Models on Physician Practices: Follow-Up Study
Physician practice engagement with alternative payment models (APMs) would be enhanced by simpler APMs, a slower pace of change, greater support for new capabilities and timely data, and reexamination of practice response to APMs with financial risk.
Oct 24, 2018
Report
Physicians Struggle to Keep Up with Changing Payment Models
Alternative payment models cause administrative burdens that take doctors away from patient care. Slowing the rate of change and simplifying payment models could help them focus on patients. And getting physicians' input on the design of new payment methods might improve their engagement.
Oct 24, 2018

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RAND Topic:
Health Care Pay for Performance

Topic Synonyms:
P4P;
Value-Based Purchasing

Research conducted by

RAND Health Care

Researcher Spotlight

Cheryl L. Damberg

Director, RAND Center of Excellence on Health System Performance

Cheryl Damberg is director of the RAND Center of Excellence on Health System Performance, distinguished chair in Health Care Payment Policy, and a principal senior economist at the RAND Corporation. Her research explores the impact of strategies to drive cost and quality improvements in health…
Anagha Alka Tolpadi

Statistical Analyst

Anagha Tolpadi (she/her) is a statistical analyst at the RAND Corporation. She conducts statistical analyses to address research questions in a variety of health policy areas, such as health equity, quality of care, patient satisfaction, and pay-for-performance. She conducts statistical analyses…

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