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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

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
News Release

Complex and Rapidly Changing Payment Models Challenge Physician Practices

Physician payment models are becoming more complex and the pace of change is increasing, creating challenges for physician practices that might hamper their ability to improve the quality and efficiency of care despite their willingness to change.

Oct 24, 2018
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
Report

RAND Medicare Advantage (MA) and Part D Contract Star Ratings Technical Expert Panel May 31st 2018 Meeting

On May 31, 2018, the RAND Corporation convened a Technical Expert Panel (TEP) to gather input on analyses that could be conducted to further enhance the Medicare Advantage (MA) and Part D Contract Star Ratings program.

Aug 23, 2018
Journal Article

Evaluation of the Social Impact Bond Trailblazers in Health and Social Care: Final Report

The Department of Health commissioned an independent evaluation of Social Impact Bond Trailblazers from PIRU, in partnership with RAND Europe, to explore their potential benefits and costs.

Jul 20, 2018
Journal Article

Loss Function-Based Evaluation of Physician Report Cards

Report card designers should consider designs that are consistent with policy goals and are implementable.

Apr 17, 2018
Journal Article

Measuring Patient-Centeredness of Care for Seriously Ill Individuals: Challenges and Opportunities for Accountability Initiatives

High quality care for seriously ill patients could be promoted by developing a nationally endorsed survey instrument that assesses patient and family experiences of serious illness care, an administrative data structure to identify the most knowledgeable respondents for the survey, and a tool kit of quality improvement approaches.

Dec 14, 2017
Research Brief

MACRA's Effects on Medicare Payment Policy and Spending

Estimates how sensitive physician behavior is to the design of alternative payment models under the Medicare Access and CHIP Reauthorization Act (MACRA).

May 3, 2017
Journal Article

The Medicare Access and CHIP Reauthorization Act: Effects on Medicare

The Medicare Access and Chip Reauthorization Act (MACRA) will decrease Medicare spending on physician services by an estimated -$35 to -$106 billion and change spending on hospital services by +$32 to -$250 billion between 2015 and 2030.

Apr 5, 2017
Journal Article

The Effects of Pay-for-Performance Programs on Health, Health Care Use, and Processes of Care: A Systematic Review

There is some evidence that pay-for-performance programs improve processes of care, but there is no clear evidence that they improve patient outcomes.

Mar 14, 2017
Commentary

Improving MACRA's Chances of Success

Starting in 2019, the Medicare Access and CHIP Reauthorization Act will integrate and potentially simplify performance measurement by combining many measures and programs. Research provides insight into how to avoid pitfalls in MACRA's rollout.

Jan 9, 2017

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RAND Topic:
Health Care Pay for Performance

Topic Synonyms:
P4P;
Value-Based Purchasing

Research conducted by

RAND Health Care