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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.

News Release

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

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

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

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

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

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

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
Journal Article

Journal Article

Understanding the Role Played by Medicare's Patient Experience Points System in Hospital Reimbursement

Patient experience points related to improvement and consistency have a small but important effect on payments to hospitals serving large proportions of disadvantaged patients under the Medicare Hospital Value-Based Purchasing program.

Sep 15, 2016
Journal Article

Implementation Processes and Pay for Performance in Healthcare: A Systematic Review

We conducted a systematic review and key informant (KI) interviews to better understand the implementation factors that modify the effectiveness of P4P (pay-for-performance).

Mar 21, 2016
Project

Small Ideas for Saving Big Health Care Dollars

Big proposals to rein in health care spending in the United States have encountered stiff political and organizational resistance. But adopting a combination of smaller ideas could save the U.S. health care system a total of up to $26 billion a year.

Mar 8, 2016
Journal Article

Journal Article

How Will Provider-Focused Payment Reform Impact Geographic Variation in Medicare Spending?

The Institute of Medicine has recently argued against a value index as a mechanism to address geographic variation in spending and instead promoted payment reform targeted at individual providers.

Jan 28, 2016
Journal Article

Journal Article

An Evaluation of Social Impact Bonds in Health and Social Care: Interim Report

This interim report describes the progress of the nine 'Trailblazer' projects that investigate the feasibility of setting up Social Impact Bond (SIB) projects in health and social care in England.

Apr 1, 2015
News Release

News Release

Details and Context of New Payment Models Are Critical to Efforts of Physician Practices to Improve Care

Physician practices are engaging in new health care payment models intended to improve quality and reduce costs, but are finding that they need help with managing increasing amounts of data and figuring out how to respond to the diversity of programs and quality metrics from different payers.

Mar 19, 2015
Report

Physicians Need Support and Guidance to Further Advance Delivery Reforms

Physicians are engaging in new health care payment models intended to improve quality and reduce costs. They are finding that they need help with managing increasing amounts of data and figuring out how to respond to the diversity of programs and quality metrics from different payers.

Mar 19, 2015
Journal Article

Journal Article

Comparison Between Clinical Registry and Medicare Claims Data on the Classification of Hospital Quality of Surgical Care

This paper aimed to estimate the effect of tobacco taxes on total mortality and cause-specific mortality in the 50 States plus the District of Columbia, USA, over the period 1970–2005 as well as the net effect on deaths averted in 2010.

Jan 28, 2015
Journal Article

More Daring Ideas to Form Health Policy: Why Not?

When it comes to health policy, there are two basic approaches: (1) cautious and careful, or (2) disruptive and daring. The former is less threatening, but what might happen if decision makers were more driven by creativity and less concerned about regulations?

Jan 23, 2015

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RAND Topic:
Health Care Pay for Performance

Topic Synonyms:
P4P;
Value-Based Purchasing

Research conducted by

RAND Health Care