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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

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
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

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

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

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

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
Journal Article

Challenges in Assessing the Process-Outcome Link in Practice

Expanded use of clinical process-of-care measures to assess the quality of health care in the context of public reporting and pay-for-performance applications led to a desire to demonstrate its value in terms of improved patient outcomes.

Jan 19, 2015
News Release

New Approach to Quality-Based Incentives Avoids Undesired Effects on Health Care Providers Who Care for Disadvantaged ...

Changing health care pay-for-performance programs to account for differences among providers in their patient characteristics can make the incentive schemes more equitable and avoid a redistribution of resources away from providers who care for socioeconomically disadvantaged patients.

Jan 14, 2015
Journal Article

New Approach to Quality-Based Incentives Avoids Undesired Effects on Health Care Providers Who Care for Disadvantaged Patients

Changing health care pay-for-performance programs to account for differences among providers in their patient characteristics can make the incentive schemes more equitable and avoid a redistribution of resources away from providers who care for socioeconomically disadvantaged patients.

Jan 9, 2015
Commentary

The Great Patient Experience Survey Myth

Patient experience with care is an essential element in any assessment of health care quality. Surveys give patients a voice and provide fair and relevant indicators that complement other metrics of health care quality to inform patients' choices and providers' decisions about how to improve care.

Dec 10, 2014
Testimony

Designing a Performance-Based Incentive Program for Physicians

Value-based payment programs may encourage providers to innovate and redesign care delivery, potentially driving improvements in quality and efficiency.

Jul 12, 2013

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RAND Topic:
Health Care Pay for Performance

Topic Synonyms:
P4P;
Value-Based Purchasing

Research conducted by

RAND Health Care