Rewarding Provider Performance: Aligning Incentives in Medicare
Institute of Medicine
Hardcover, 280 pages
Institute of Medicine / National Academy Press
(click below for the very best currently available price for this title)
Pay for performance is a strategy to offer incentives to providers for delivering higher quality care as measured by selected evidence-based standards and procedures. Its goal is not simply to reward those who perform well or to reduce costs. Rather, it is a mechanism to align incentives to encourage ongoing improvement in a way that will ensure high-quality care for all.
This study will serve as a blueprint for providers - and even for Medicare administration for the future.
It offers providers the opportunity to develop recommended internal programs of incentives, thereby easing the trend to come from payers.
The current Medicare payment system is broken. It provides few disincentives for overuse, under use or misuse of care, and does not reward efficiency. Fundamental change requires a commitment by all Medicare providers to deliver high quality care efficiently. Pay for performance constitutes one key component needed for the transformation of the health care payment system, but cannot achieve this transformation alone.
While over 100 performance incentive and physician reward programs have been introduced over the past decade, a robust evidence-base on the effectiveness of these programs is not yet available. Pay for performance does, however, offer significant promise and can begin now by building off other strategies for improvement. Payment incentives should be structured to encourage all providers to deliver high-quality care efficiently. In particular, providers should assume shared accountability for transitions between settings of care and coordinate care in treating patients with chronic diseases.
With this book as a guide, pay for performance in Medicare should be introduced within a learning system that has the capacity to assess early experiences, adjust for unintended consequences, and evaluate impact.
The Institute for Healthcare Improvement (IHI) is a not-for-profit organization driving the improvement of health by advancing the quality and value of health care. IHI is a reliable source of energy, knowledge, and support for a never-ending campaign to improve health care worldwide. We develop and nurture will, energizing a movement for profound change in health care. We spread improvement knowledge across the globe, and provide methods, tools, and other supports, largely through partnerships, for thousands of health care organizations to turn knowledge into improved results. We initiate and support innovation efforts, so as to discover, cultivate, and demonstrate the feasibility of new, more capable, designs. We exercise academic rigor in this work. We work to change the skills, attitudes, and knowledge of the workforce, both in the ongoing development of young professionals and in life-long education, so as to reduce profession-specific silos that limit collaborative effort for the well-being of patients. We seek to improve joy in work, and to help all who work in health care to become better able to help improve care.
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