Hospitals participating in one or more voluntary Medicare value-based reform programs were less likely to readmit patients within 30 days of discharge than non-participating hospitals.
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.
Congress is considering how to update TRICARE, the U.S. Department of Defense health benefits program. In this Perspective, the authors evaluate two existing proposals that incorporate value-based purchasing and describe a hybrid alternative.
Changing incentives in the health care sector and the move to value-based payment models will force device manufacturers to redirect investments from the spectacular toward the prudent—lower cost, less sexy.
A medical home intervention that paid bonuses to physician practices based on financial savings showed significant improvements in quality and use of some medical services relative to comparison practices.
The Affordable Care Act has officially been part of the U.S. health care landscape for five years. We reflect on the twists and turns that followed its passage and the RAND research that informed debates along the way, and look ahead to the future of the ACA.
After a decade of experimentation with reforms that give health providers financial incentives to improve performance, relatively little is known about how to best execute such strategies or judge their success.
Reviews what has been learned over the past decade about performance-based payment strategies in health care and offers recommendations for the design, implementation, and monitoring and evaluation of value-based purchasing programs.
After a decade of experimentation with reforms that give health providers financial incentives to improve performance, relatively little is known about how to best execute such strategies or judge their success.
2014 will be an important year for the Patient Protection and Affordable Care Act. Health insurance exchanges will offer people new ways to buy insurance. Medicaid will expand in many states. And people without “minimum essential coverage” may have to pay a fee.
Public and private sector purchasers are actively working to design value-based payment programs to achieve the goals of improved quality and more efficient use of health care resources. How these programs are designed is a complex undertaking and one that will determine the likelihood of their success.
Alignment with best P4P practices varies across Medicare programs; the program for Medicare Advantage aligns most strongly. It is unclear which P4P design elements are critical for quality improvement. Unintended consequences of design features are poorly understood.
Providers can dramatically improve American health care by focusing on “value” instead of “volume,” eliminating wasteful and inappropriate care, applying the best available evidence to their practices, and enhancing patient safety.
Medicare's payment for physician work and malpractice liability expenses is the same regardless of where a service is provided, but payments differ for facility-related components of care.
As the health care industry, employers, and government officials seek to control the growth of health spending, new efforts are needed to develop and refine quality-of-care and other performance measures that can assure changes will improve medical care and do not harm patients.
Health care spending reforms should be met with new efforts to develop and refine quality of care and other performance measures in order to assure that any changes will improve medical care and not harm patients.
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.
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.
