Quality Incentives: The Case Of U.K. General Practitioners

Smith, Peter; York, Nick

doi:10.1377/hlthaff.23.3.112

Cited by 84 publications

(62 citation statements)

References 8 publications

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“…General practitioners in the UK have traditionally been compensated under a mixed reimbursement model including capitation (40%), salary (30%), capital and information technology (15%), and fee-forservice, including quality-based incentives (15%). 29 A new general practitioner reimbursement contract was introduced in April 2004, which will increase primary care expenditures by £1.9 billion per year (an increase of 33% over 3 years). A quality incentive system, involving 146 indicators across 7 areas of practice, is central to this contract.…”

Section: Mixed Reimbursement Modelmentioning

confidence: 99%

Report on Financing the New Model of Family Medicine

Spann¹

2004

The Annals of Family Medicine

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PURPOSE To foster redesigning the work and workplaces of family physicians, this Future of Family Medicine task force was created to formulate and recommend a fi nancial model that sustains and promotes a thriving New Model of care by focusing on practice reimbursement and health care fi nances. The goals of the task force were to develop a fi nancial model that assesses the impact of the New Model on practice fi nances, and to recommend health care fi nancial policies that, if implemented, would be expected to promote the New Model and the primary medical care function in the United States for the next few decades. METHODSThe members of the task force refl ected a wide range of professional backgrounds and expertise. The group met in person on 2 occasions and communicated by e-mail and conference calls to achieve consensus. A marketing study was carried out using focus groups to test the concept of the New Model with consumers. External consultants with expertise in health economics, health care fi nance, health policy, and practice management were engaged to assist the task force with developing the microeconomic (practice level) and macroeconomic (societal level) fi nancial models necessary to achieve its goals. Model assumptions were derived from the published medical literature, existing practice management databases, and discussions with experienced physicians and other content experts. The results of the fi nancial modeling exercise are included in this report. The initial draft report of the fi ndings and recommendations was shared with a reactor panel representing a broad spectrum of constituencies. Feedback from these individuals was reviewed and incorporated, as appropriate, into the fi nal report. RESULTSThe practice-level fi nancial model suggests that full implementation of the New Model of care within the current fee-for-service system of reimbursement would result in a 26% increase in compensation (from $167,457 to $210,288 total annual compensation) for prototypical family physicians who maintain their current number of work hours. Alternatively, physicians could choose to decrease their work hours by 12% and maintain their current compensation. This result is sensitive to physician practice group size. The societal level fi nancial model shows that modifi cations in the current reimbursement system could lead to further improvements in compensation for family physicians practicing the New Model of care. Reimbursement for e-visits and chronic disease management could further increase total annual compensation to $229,849 for prototypical family physicians maintaining their current number of work hours. The widespread introduction of quality-based physician incentive bonus payments similar to some current programs that have been implemented on a limited basis could further increase total annual compensation up to $254,500. The adoption of a mixed reimbursement model, which would add an annual per-patient fee, a chronic care bonus, and an overall performance bonus to the current reimbursem...

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Section: Mixed Reimbursement Modelmentioning

confidence: 99%

Report on Financing the New Model of Family Medicine

Spann¹

2004

The Annals of Family Medicine

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“…The primary reference for the use of physician incentives is the Quality and Outcomes Framework (QOF) program, established by the UK National Health Service (NHS) to provide financial incentives to general practitioners (GPs) to achieve better health outcomes and higher patient satisfaction 33 . In this program, each general practice was scored on over 100 performance indicators according to the measured quality of care it delivered.…”

Section: Physician-oriented Programsmentioning

confidence: 99%

“…In this program, each general practice was scored on over 100 performance indicators according to the measured quality of care it delivered. The framework was annually revised and the latest framework consists of 5 domains-Clinical; Public Health; Public Health -Additional Services; Patient Experience; Quality and Productivity 33 . This is an alternative approach to the common, fee-per-patient approach, which incentivises unnecessary tests and servicing.…”

Section: Physician-oriented Programsmentioning

confidence: 99%

Review of cardiovascular disease prevention and control programs: international experience and challenges in China

Tan¹,

et al. 2016

ICFJ

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Major cardiovascular risk factors in China, such as hyperlipidemia, hypertension, dietary factors, exposure to tobacco, diabetes, obesity and physical inactivity, have contributed to deteriorating trends in cardiovascular disease (CVD) deaths. In past years, a number of CVD prevention programs have been initiated in European and American countries and successfully brought down CVD related death rate by involving various parties such as physicians, patients, government agencies and payers. However, there is rare published literature that systemically reviewed such experience, which would be highly valuable for China and other countries with high CVD burden. In this article, we review the published literature on CVD prevention and control programs and report on interviews of local and foreign experts to provide recommendations for China-specific CVD prevention and control programs. In order to provide practical suggestions, we describe the type of programs as patient, physician, pharmacist, nurse, or payer-focused. Based on this evidence and identified challenges in China, programs focusing on disease management, treatment adherence, physician/health care provider education, financial incentives, and integrated healthcare are recommended for the prevention and control of CVD in China.

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“…Alguns autores defendem que os incentivos podem ajudar no alcance dos objetivos da polí-tica de saúde, favorecendo o acesso aos serviços de saúde necessários aos cidadãos, garantindo alta qualidade do atendimento e melhoria da equidade, bem como promovendo a utilização efetiva e eficiente dos recursos de saúde 35,36 . No entanto, embora programas de incentivos estejam sendo utilizados no planejamento e implementação de ações e serviços de saúde, poucas são as evidências existentes sobre a sua efetividade ou as suas potenciais consequências intencionais e não intencionais (externalidades), com os respectivos efeitos sobre a relação profissional/paciente e impactos sobre a saúde da população 33,37,38 .…”

Section: Introductionunclassified

O uso de contratos de gestão e incentivos profissionais no setor público de saúde

Ditterich

Moysés

2012

Cad. Saúde Pública

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A gestão por resultados constitui um dos pilares da reforma na gestão pública, inclusive na área da saúde, tendo como principais inovações: a institucionalização de contratos de gestão e a utilização de incentivos profissionais. O objetivo deste artigo de revisão de literatura é apresentar e discutir a utilidade e aplicabilidade de contratos de gestão e incentivos profissionais na gestão por resultados no setor público de saúde. A gestão por resultados só será possível quando existir corresponsabilidade e compromisso mútuo entre os trabalhadores e o nível diretivo. Por isso, as metas preestabelecidas devem ser pactuadas entre todos os atores envolvidos e avaliadas de forma periódica para que os incentivos profissionais sejam garantidos. Para efetivamente aumentar a responsabilização sobre os resultados desejados é preciso aprimorar os mecanismos de controle e monitoramento, definir de forma mais precisa indicadores e seus padrões no campo da assistência e da gestão, capacitar as partes envolvidas na elaboração do plano e aperfeiçoar o uso de incentivos profissionais.

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Quality Incentives: The Case Of U.K. General Practitioners

Cited by 84 publications

References 8 publications

Report on Financing the New Model of Family Medicine

Report on Financing the New Model of Family Medicine

Review of cardiovascular disease prevention and control programs: international experience and challenges in China

O uso de contratos de gestão e incentivos profissionais no setor público de saúde

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