Pay-For-Service Payment Model

1025 Words 5 Pages
The United States has been in search for a replacement to the fee-for-service payment model, which has been scrutinized for promoting volume while undervaluing quality in the delivery of health care. The pay-for-performance assessments have indicated some positive results. Incentive programs around the United States, such as the Hill Physicians Medical Group, have been successfully implemented. They are sharing valuable insight on how to help assist the process. Studies from Gohari, Ahmadloo, Boroujeni and Hosseinipour discuss the importance of intrinsic and extrinsic rewards for producing high work performance outcomes (2013). Torchiana, Colton, Rao, Lenz, Meyer and Ferris identify the ideal target performance lengths for receiving evaluation …show more content…
The ACA encourages experimentation to identify effective designs and programs for the use of pay-for-performance approaches (James, 2012). They were designed to reduce hospital readmissions, decrease hospital-acquired conditions, and measure value-based purchasing programs. The programs deduct or enhance the hospital’s Medicare reimbursement based on their results. Generally, hospitals are making the quality adjustments necessary to gain a bonus, but some complain that it is an incomplete portrayal of performance that leaves gaps and challenges in the metrics. It is also feared that data collected maybe unreliable because of the penalties for reporting infections and shortcomings (Shapiro, 2015). Other approaches and policy adjustments are being currently analyzed. Concerns regarding the impact of pay-for-performance approaches on lower economic and disadvantaged populations have been raised. There are worries that health providers may avoid patients that are more likely to lower their performance scores and decrease their rewards (James, 2012). This would increase racial and ethnic disparities in health. Language barriers, transportations limitations, or child care are reasons for decreased patient …show more content…
Hundreds of healthcare facilities have implemented similar programs to achieve their goals. Understanding the possibilities for error and gaps in care will help limit problems and develop improved systems. Under the Affordable Care Act, pay-for-performance programs are likely to increase across the US health care system. Evaluations of these systems should be analyzed and compared in effort to gain new innovative approaches. Information from case studies and evidence-based research provides valuable insight on what to consider when establishing physician incentive

Related Documents

Related Topics