Paying For Performance: Medicare Should Lead

Berwick, Donald M.; DeParle, Nancy Ann; Eddy, David M.; Ellwood, Paul M.; Enthoven, Alain C.; Halvorson, George; Kizer, Kenneth W.; McGlynn, Elizabeth A.; Reinhardt, Uwe E.; Reischauer, Robert D.; Roper, William L.; Schaeffer, Leonard D.; Wennberg, John E.; Wilensky, Gail R.

doi:10.1377/hlthaff.22.6.8

Cited by 76 publications

(41 citation statements)

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“…7 Many managed care and health system entities are seeking these types of programs to help counteract the high cost of providing care for such chronic conditions as heart failure, asthma, and diabetes. [8][9][10][11] More than half of commercial health maintenance organizations (HMOs) are utilizing QCPs. 12 However, the Centers for Medicare and Medicaid Services (CMS) conducted a 6-year Premier Hospital Quality Incentive Demonstration (HQID) and found no evidence that large hospital-based QCPs led to a 30-day mortality decrease.…”

Section: What This Study Addsmentioning

confidence: 99%

Quality Compensation Programs: Are They Worth All the Hype? A Comparison of Outcomes Within a Medicare Advantage Heart Failure Population

Esse¹,

Serna²,

Chitnis³

et al. 2013

JMCP

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BACKGROUND: Quality compensation programs (QCPs), also known as payfor-performance programs, are becoming more common within managed care entities. QCPs are believed to yield better patient outcomes, yet the programs lack the evidence needed to support these claims. We evaluated a QCP offered to network primary care physicians (PCPs) within a Medicare managed care plan to determine if a positive correlation between outcomes and the program exists.

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Section: What This Study Addsmentioning

confidence: 99%

Quality Compensation Programs: Are They Worth All the Hype? A Comparison of Outcomes Within a Medicare Advantage Heart Failure Population

Esse¹,

Serna²,

Chitnis³

et al. 2013

JMCP

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“…While there is some debate as to whether these efforts are serving the healthcare community well, P4P is already woven into today's healthcare fabric. [40][41][42] As a result, healthcare entities are often faced with the harsh reality that the coming year's contractual goals are at risk, resulting in stopgap HIT solutions applied as afterthoughts to existing information systems. As has been observed recently by Crosson et al, 43 the mere act of applying a technology to a particular process (such as adding a reminder system to an EMR) does not guarantee improvement.…”

Section: Introductionmentioning

confidence: 99%

Designing healthcare information technology to catalyse change in clinical care

Lester¹,

Zai²,

Grant³

et al. 2008

Journal of Innovation in Health Informatics

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“…They use multiple proprietary (and often expensive) database software and a variety of formats that often do not communicate well with each other, if they can communicate at all. The result is an inefficient medical infostructure where end users are unable to transform the terabytes of data into useful information, which could guide better health care spending priorities and implementation strategies 1 .…”

Section: Introductionmentioning

confidence: 99%

Overcoming health inequity: potential benefits of a patient-centered open-source public health infostructure

Marques¹,

Filho

August³

2008

Cad. Saúde Pública

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The past 20 years have witnessed an astonishing increase in computational power and an incredible reduction in the cost of contemporary computer systems, but the public health infostructure in most countries has not changed significantly. This article discusses the potential benefits of applying patient-centered infostructure at the primary medical "points-of-care" services, based on networked integrated open-source technology and programming standards to develop tools to detect and reduce health inequalities. Such systems, which could be implemented from the local to the national level, would enable the expansion of evidence-based medicine, clearer identification of health inequalities, and more accurate cost-benefit analyses. In addition, the public health sector could link such databases to traditional Electronic Patient Record (EPR) systems at a greatly reduced cost by promoting the use of standards-based formats for data transfer and storage. Ultimately, the new health infostructure would help decrease health inequity. In fact, developing countries like Brazil, India, and South Africa are well-positioned to take advantage of the open-source movement and "leapfrog" countries burdened by legacy systems.

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Paying For Performance: Medicare Should Lead

Abstract: O p e n L e t t e r

Cited by 76 publications

References 0 publications

Quality Compensation Programs: Are They Worth All the Hype? A Comparison of Outcomes Within a Medicare Advantage Heart Failure Population

Quality Compensation Programs: Are They Worth All the Hype? A Comparison of Outcomes Within a Medicare Advantage Heart Failure Population

Designing healthcare information technology to catalyse change in clinical care

Overcoming health inequity: potential benefits of a patient-centered open-source public health infostructure

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