Impact of Provider Incentives on Quality and Value of Health Care

Doran, Timothy; Maurer, Kristin A.; Ryan, Andrew M.

doi:10.1146/annurev-publhealth-032315-021457

Cited by 75 publications

(62 citation statements)

References 92 publications

(89 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The complex, wide-ranging, and evolving bonus-based incentive structure of the program may be a less effective design than the simpler, more narrowly targeted, penalty-based design of the HRRP. 29 …”

Section: Discussionmentioning

confidence: 99%

Changes in Hospital Quality Associated with Hospital Value-Based Purchasing

et al. 2017

Self Cite

View full text Add to dashboard Cite

BACKGROUND Starting in fiscal year 2013, the Hospital Value-Based Purchasing (HVBP) program introduced quality performance–based adjustments of up to 1% to Medicare reimbursements for acute care hospitals. METHODS We evaluated whether quality improved more in acute care hospitals that were exposed to HVBP than in control hospitals (Critical Access Hospitals, which were not exposed to HVBP). The measures of quality were composite measures of clinical process and patient experience (measured in units of standard deviations, with a value of 1 indicating performance that was 1 standard deviation [SD] above the hospital mean) and 30-day risk-standardized mortality among patients who were admitted to the hospital for acute myocardial infarction, heart failure, or pneumonia. The changes in quality measures after the introduction of HVBP were assessed for matched samples of acute care hospitals (the number of hospitals included in the analyses ranged from 1364 for mortality among patients admitted for acute myocardial infarction to 2615 for mortality among patients admitted for pneumonia) and control hospitals (number of hospitals ranged from 31 to 617). Matching was based on preintervention performance with regard to the quality measures. We evaluated performance over the first 4 years of HVBP. RESULTS Improvements in clinical-process and patient-experience measures were not significantly greater among hospitals exposed to HVBP than among control hospitals, with difference-in-differences estimates of 0.079 SD (95% confidence interval [CI], −0.140 to 0.299) for clinical process and −0.092 SD (95% CI, −0.307 to 0.122) for patient experience. HVBP was not associated with significant reductions in mortality among patients who were admitted for acute myocardial infarction (difference-in-differences estimate, −0.282 percentage points [95% CI, −1.715 to 1.152]) or heart failure (−0.212 percentage points [95% CI, −0.532 to 0.108]), but it was associated with a significant reduction in mortality among patients who were admitted for pneumonia (−0.431 percentage points [95% CI, −0.714 to −0.148]). CONCLUSIONS In our study, HVBP was not associated with improvements in measures of clinical process or patient experience and was not associated with significant reductions in two of three mortality measures. (Funded by the National Institute on Aging.)

show abstract

Section: Discussionmentioning

confidence: 99%

Changes in Hospital Quality Associated with Hospital Value-Based Purchasing

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…Incentives and compensation for the healthcare providers should also be introduced, reviewed and updated for effective quality integrated care outcome. The act of financial incentive will serve as a motivation for healthcare providers (Doran, Maurer, & Ryan, 2017;Tsiachristas, 2016). Naturally, PCC in healthcare services will not emerge without a proactive change given the amount of challenges encountered by the designed approaches to achieve integration in the healthcare services.…”

Section: Personnel Remuneration In Phcmentioning

confidence: 99%

Trends in Patient-Centered Care in South West Nigeria: A Holistic Assessment of the Nurses Perception of Primary Healthcare Practice

Lateef¹,

Mhlongo²

2020

GJHS

View full text Add to dashboard Cite

BACKGROUND: A key dimension of a quality healthcare to patients is patient-centered care approach which is increasingly gaining recognition worldwide. However, this concept is not fully implemented in practice. AIM: The aim of this study is to provide outcomes from assessment of nurses’ perceptions about patient-centered care and the current trends in Primary Health Care system in South West Nigeria. METHODS: This study employed a qualitative participatory action research study approach and conducted a semi-structured individual interview with thirty-five nurses and four focus group discussions in Osun State South West Nigeria Primary Health Care centres. RESULTS: Primary Health Care (PHC) nurses perceived and described patient-centered care (PCC) as a global approach to improve and enhance nursing care to foster patient participation. The narratives were categorised into two: positive and negative perception. Ten main themes emerged: (I) Attitude of the nurses (ii) Lack of enforcement and implementation, (iii) Experience of the nurses, (iv) Quality-Caring, (v) Effective communication with patient, (vi) Motivated and Proactive healthcare, (vii) Sharpen the form of care, (viii) Outcome and after-effect driven healthcare, (ix) Approved support, and (x) Guarantor of service and motivation. CONCLUSION: Our participatory action research study on the assessment of nurses’ perception on the utilization of PCC at the PHC for effective and quality healthcare service revealed the importance of nurses’ role, acceptability of PCC and current nursing care practice at the Primary Health Care (PHC) rural community setting. Nurses as healthcare providers expressed PCC as a common and global approach that would enhance patient experiences and improves the quality of nursing healthcare delivery through integration of PCC and healthcare service at the PHC healthcare system.

show abstract

“…Regarding the HVBP, the literature generally finds little or no effect on hospital quality (Ryan et al, 2015;Doran et al, 2017;Norton et al, 2017;Ryan et al, 2017). Examining data from 2015 to 2016, Norton et al (2017) did find some hospital response to the HVBP, but this response was in specific areas with the greatest marginal revenue rather than those areas with larger quality benefits.…”

Section: Policy Background: the Hrrp And Hvbpmentioning

confidence: 99%

Who Pays in Pay for Performance? Evidence from Hospital Pricing

Darden

McCarthy

Barrette³

2018

View full text Add to dashboard Cite

and the Federal Trade Commission. Finally, we acknowledge the Health Care Cost Institute (HCCI), along with companies providing data (Aetna, Humana, and UnitedHealthcare) used in this analysis. All data analyses were conducted while Eric Barrette was Director of Research for HCCI. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research. NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.

show abstract

Impact of Provider Incentives on Quality and Value of Health Care

Cited by 75 publications

References 92 publications

Changes in Hospital Quality Associated with Hospital Value-Based Purchasing

Changes in Hospital Quality Associated with Hospital Value-Based Purchasing

Trends in Patient-Centered Care in South West Nigeria: A Holistic Assessment of the Nurses Perception of Primary Healthcare Practice

Who Pays in Pay for Performance? Evidence from Hospital Pricing

Contact Info

Product

Resources

About