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Health Care Payment Approaches

Journal Article
Where Americans Get Acute Care: Increasingly, It's Not at Their Doctor's Office
Only 42 percent of the 354 million annual visits in the U.S. for acute care—treatment for newly arising health problems—are made to patients' personal physicians. The rest are made to emergency departments (28 percent), specialists (20 percent), or outpatient departments (7 percent).
Sep 1, 2010
Commentary
Physician Compensation, Cost, and Quality
Pay for performance, transparency, and other innovative ways of compensating physicians will work only if, at the same time, the system for providing care is changed to one that has clear objectives and provides specific tools to help physicians achieve those objectives, writes Robert H. Brook.
Aug 18, 2010
Research Brief
Are Performance-Based Accountability Systems Effective? Evidence from Five Sectors
Creating an effective Performance-Based Accountability System (PBAS) requires careful attention to selecting an appropriate design for the PBAS, given the context in which it is to operate, and to monitor, evaluate, and adjust the system, as appropriate.
Jul 28, 2010
Report
Performance-Based Accountability Systems for Public Services
Evidence supports continued experimentation with and adoption of performance-based accountability systems (PBAS) in various sectors: child care, education, health care, public health emergency preparedness, and transportation. However, PBAS design and its prospects for success depend on the context in which it will operate.
Jul 21, 2010
Report
Analyzing the Operation of Performance-Based Accountability Systems for Public Services
Empirical evidence of the effects of performance-based public management is scarce. But a framework for organizing the empirical information we do have could identify individuals or organizations that must change to improve performance, select an effective incentive structure, and choose performance measures that inform the incentive structure appropriately.
Jul 14, 2010
Journal Article
Using the Lessons of Behavioral Economics to Design More Effective Pay-for-Performance Programs
Although pay for performance incentives are increasingly popular, the healthcare literature shows that these have had minimal effect. Design improvements in these programs can enhance their effectiveness.
Jul 1, 2010
News Release
Performance-Based Payments for Primary Care Providers May Worsen Disparities in Medical Care
Rewarding primary care physicians for providing better care to patients could end up widening medical disparities experienced by poorer people and by minorities. Increasing the number of primary care physicians is also not enough to boost U.S. health care quality and lower costs.
May 4, 2010
Journal Article
Performance-Based Payments for Primary Care Providers May Worsen Disparities in Medical Care
Rewarding primary care physicians for providing better care to patients could end up widening medical disparities experienced by poorer people and by minorities. Increasing the number of primary care physicians is also not enough to boost U.S. health care quality and lower costs.
May 1, 2010
Report
Increase the Use of "Bundled" Payment Approaches
This document explores how increased use of bundled payment approaches would affect health system performance along nine dimensions.
Jan 8, 2010
Journal Article
Usual Care Psychotherapy for Depression in a Large Managed Behavioral Health Organization
Many depressed patients are receiving recommended psychotherapy but better tools are needed to monitor and improve the quality of usual psychotherapeutic care.
Jan 1, 2010
Journal Article
Physician Compensation, Cost, and Quality
Pay-for-performance, transparency, and other innovative ways of compensating physicians will only work if, at the same time, the system for providing care has clear objectives and specific tools to help physicians achieve those objectives.
Jan 1, 2010
Journal Article
Risk-adjusted Capitation Rates for Children: How Useful Are the Survey-Based Measures?
National health surveys can provide information, including measures of special health care needs, that can improve risk-adjustment models and help provide appropriate payments to managed-care plans serving vulnerable children.
Jan 1, 2010
Journal Article
Can You Get What You Pay For? Pay-for-Performance and the Quality of Healthcare Providers
One-liner abstract (description): Despite the popularity of pay-for-performance (P4P) among health policymakers and private insurers as a tool for improving quality of care, there is little empirical basis for its effectiveness.
Jan 1, 2010
Journal Article
The Effect of Performance-Based Financial Incentives on Improving Patient Care Experiences: A Statewide Evaluation
Pay-for-performance incentives improve physician-patient communication, care coordination, and interaction with office staff.
Dec 1, 2009
Journal Article
Reliability of Patient Responses in Pay for Performance Schemes: Analysis of National General Practitioner Patient Survey Data in England
Assess the robustness of patient responses to a new national survey of patient experience as a basis for providing financial incentives to doctors.
Oct 24, 2009
Report
Hospital Pay for Performance
Researchers explore how hospital pay for performance would affect health system performance with respect to spending, patient experience, health, waste, consumer financial risk, coverage, and capacity.
Oct 12, 2009
Report
Physician Pay for Performance
This document explores how physician pay for performance (P4P) programs would affect health system performance along nine dimensions.
Oct 12, 2009
News Release
Strategies Outlined to Test New Payment Models for Health Care
A new RAND study outlines methods that might be used to test a novel payment system for medical care that would provide doctors, hospitals and other health providers a set fee for treating an ailment such as hip replacement surgery.
Sep 29, 2009
Research Brief
Controlling Health Care Spending in Massachusetts
In 2006, Massachusetts passed landmark legislation ensuring near-universal health insurance coverage to its residents, but rising costs threaten the initiative; this policy brief assesses 21 options for controlling health care spending in the state.
Sep 10, 2009
Journal Article
Strategies Outlined to Test New Payment Models for Health Care
A new study outlines methods that might be used to test a novel payment system for medical care that would provide doctors, hospitals and other health providers a set fee for treating an ailment such as hip replacement surgery.
Sep 1, 2009

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