Incentives in Rheumatology: the Potential Contribution of Physician Responses to Financial Incentives, Public Reporting, and Treatment Guidelines to Health Care Sustainability

Harrison, Mark; Milbers, Katherine; Mihic, Tamara; Anis, Aslam H.

doi:10.1007/s11926-016-0596-6

Cited by 4 publications

(3 citation statements)

References 33 publications

(57 reference statements)

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“…The recent lit er a ture shows that while many clinicians support the use of financial incen tives to improve care delivery and quality in princi ple, many of the concerns identified in our prior study persist, and clinicians express reservations about whether PFP schemes as currently designed can achieve their goals (Harrison et al, 2016). The availability, accuracy, and timeliness of data to aid in quality improvement initiatives is cited as an impor tant prerequisite for successful PFP programs, but this is an area where gaps are frequently observed (Alidina et al, 2014;Abra hamson et al, 2015;Hussain et al, 2016).…”

Section: Impact On Physiciansmentioning

confidence: 86%

Effects of Health Care Payment Models on Physician Practice in the United States: Follow-Up Study

Friedberg¹,

Chen²,

Simmons³

et al. 2018

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Limited Print and Electronic Distribution RightsThis document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.Support RAND Make a tax-deductible charitable contribution at www.rand.org/giving/contribute www.rand.org For more information on this publication, visit www.rand.org/t/RR2667

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Section: Impact On Physiciansmentioning

confidence: 86%

Effects of Health Care Payment Models on Physician Practice in the United States: Follow-Up Study

Friedberg¹,

Chen²,

Simmons³

et al. 2018

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“…Given the ambiguity of those codes, additional research is required to determine what these visits are for or driven by, and how innovations in models of care and quality care initiatives could be implemented to better align patient needs with the clinical services delivered. This could include addressing physician shortages [30], incentivizing quality care delivery [31], developing care pathways that are patient-centered, and exploring collaborative care models involving interdisciplinary rheumatology care models to ensure broader access to healthcare services [32].…”

Section: Discussionmentioning

confidence: 99%

Emergency department utilization by persons with rheumatoid arthritis: a population-based cohort study

Contreras,

McLane,

Barber

et al. 2024

Rheumatol Int

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Some emergency department (ED) visits by persons with rheumatoid arthritis (RA) may be avoidable. This study aims to describe ED use by persons with RA in Alberta, Canada over a 10-year period. Using linked population-based administrative datasets, the annual frequency of ED visits, timing of visits, acuity at presentation assessed (Canadian Triage Acuity Scale (CTAS)), return visits within 72 h, and final disposition were assessed. Most responsible diagnoses assessed by the ED provider were categorized. Between 2008 and 2017, a total of 48,633 persons with RA had 416,964 unique ED visits. There was a 41% relative increase in visits over the study period and within a fiscal year 37% of persons with RA on average attended an ED. Half of the visits were assessed as CTAS 4 ‘Less Urgent’ (31%) and CTAS 5 ‘Non-Urgent’ (19%). No specific diagnosis could be assigned in 36% of visits and RA was listed as the most responsible diagnosis in 2.5% of all visits. Hospital admissions, occurring on average for 14% of ED visits, increased by 15% over the 10 years, and were rare for CTAS 4 (6.4%) and CTAS 5 (1.4%) presentations. Male patients (difference to female 1.2%, 95%CI 0.6, 1.7) and urban patients (difference to rural 8.4%, 95%CI 7.7, 9.2) were more frequently admitted to hospital. Persons with RA have increased ED utilization over time, with a significant volume of less urgent and non-urgent visits. Opportunities for appropriate ambulatory care provision to reduce acute care use should be identified.

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“…Extensive analyses in both outpatient and inpatient settings tend to show positive effects of P4P in the treatment of these (Van Herck et al, 2010), suggesting the utilization of P4P for further chronic conditions like rheumatic diseases. Nevertheless and despite the trend to develop P4P instruments for specific indications, remuneration schemes that are linked to quality have not been widely used in the field of rheumatology (Harrison et al, 2016). In addition, their effectiveness in promoting higher quality of care needs scientific inquiry and evaluation (Bombardier & Mian, 2013).…”

Section: Introductionmentioning

confidence: 99%

Patient-Report-Outcome-Measure and Incentives for Inpatient Chronic Care in Germany

Romeyke¹,

Nöhammer²,

Stummer³

2020

GJHS

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INTRODUCTION: In general, incentive tools like pay for performance (P4P) have positive effects regarding treatment quality and financial outcomes. As they are applicable to the clinical management of chronic conditions like asthma and diabetes, this article analyses their potential for multimodal complex treatment of chronic rheumatic diseases. METHODS: Cost data for chronic rheumatic diseases with and without specified complex treatments and their respective remuneration are compared to permit specific statements regarding incentive aspects in a DRG setting. Moreover, several standardized Patient-Report-Outcome-Measures (PROMs) are considered in the context of complex treatment to allow not only for efficiency, but also effectiveness evaluation. RESULTS: In total, 375 patients with complex treatment for rheumatic conditions were surveyed from 2013 to 2018. The incentive is slightly below (4,821.05 €) the costs incurred for complex treatments (4,972.44 €). The results of the used PROMs are positive as pain intensity decreased considerably (p <.001, r=0.75) and mental state complaints were reduced (p <.001). CONCLUSIONS: PROMs are valid instruments to capture changes in patient well-being. They also help to improve clinical operations and can be used for benchmarking. The P4P approach should cover the costs incurred to ensure the incentive structure.

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Incentives in Rheumatology: the Potential Contribution of Physician Responses to Financial Incentives, Public Reporting, and Treatment Guidelines to Health Care Sustainability

Cited by 4 publications

References 33 publications

Effects of Health Care Payment Models on Physician Practice in the United States: Follow-Up Study

Effects of Health Care Payment Models on Physician Practice in the United States: Follow-Up Study

Emergency department utilization by persons with rheumatoid arthritis: a population-based cohort study

Patient-Report-Outcome-Measure and Incentives for Inpatient Chronic Care in Germany

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