Pay for performance: Difference between revisions
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In [[health care delivery]], '''pay for performance''', also called '''incentive reimbursement''', is "a scheme which provides reimbursement for the health services rendered, generally by an institution, and which provides added financial rewards if certain conditions are met. Such a scheme is intended to promote and reward increased efficiency and cost containment, with better care, or at least without adverse effect on the quality of the care rendered."<ref>{{MeSH}}</ref> | In [[health care delivery]], '''pay for performance''', also called '''incentive reimbursement''', is "a scheme which provides reimbursement for the health services rendered, generally by an institution, and which provides added financial rewards if certain conditions are met. Such a scheme is intended to promote and reward increased efficiency and cost containment, with better care, or at least without adverse effect on the quality of the care rendered."<ref>{{MeSH}}</ref> | ||
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==Studies of effectiveness== | ==Studies of effectiveness== | ||
Controlled studies show conflicting results.<ref name=" | Controlled studies show conflicting results.<ref name="pmid23134382">{{cite journal| author=Sutton M, Nikolova S, Boaden R, Lester H, McDonald R, Roland M| title=Reduced mortality with hospital pay for performance in England. | journal=N Engl J Med | year= 2012 | volume= 367 | issue= 19 | pages= 1821-8 | pmid=23134382 | doi=10.1056/NEJMsa1114951 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23134382 }} </ref><ref name="pmid17259444">{{cite journal| author=Lindenauer PK, Remus D, Roman S, Rothberg MB, Benjamin EM, Ma A et al.| title=Public reporting and pay for performance in hospital quality improvement. | journal=N Engl J Med | year= 2007 | volume= 356 | issue= 5 | pages= 486-96 | pmid=17259444 | doi=10.1056/NEJMsa064964 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17259444 }} </ref><ref name="pmid22455751">{{cite journal| author=Jha AK, Joynt KE, Orav EJ, Epstein AM| title=The long-term effect of premier pay for performance on patient outcomes. | journal=N Engl J Med | year= 2012 | volume= 366 | issue= 17 | pages= 1606-15 | pmid=22455751 | doi=10.1056/NEJMsa1112351 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22455751 }} </ref><ref name="pmid21901722">{{cite journal| author=Scott A, Sivey P, Ait Ouakrim D, Willenberg L, Naccarella L, Furler J et al.| title=The effect of financial incentives on the quality of health care provided by primary care physicians. | journal=Cochrane Database Syst Rev | year= 2011 | volume= | issue= 9 | pages= CD008451 | pmid=21901722 | doi=10.1002/14651858.CD008451.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21901722 }} </ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
|+ Major ecological studies of pay for performance.<ref name=" | |+ Major ecological studies of pay for performance.<ref name="pmid23134382">{{cite journal| author=Sutton M, Nikolova S, Boaden R, Lester H, McDonald R, Roland M| title=Reduced mortality with hospital pay for performance in England. | journal=N Engl J Med | year= 2012 | volume= 367 | issue= 19 | pages= 1821-8 | pmid=23134382 | doi=10.1056/NEJMsa1114951 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23134382 }} </ref><ref name="pmid17259444">{{cite journal| author=Lindenauer PK, Remus D, Roman S, Rothberg MB, Benjamin EM, Ma A et al.| title=Public reporting and pay for performance in hospital quality improvement. | journal=N Engl J Med | year= 2007 | volume= 356 | issue= 5 | pages= 486-96 | pmid=17259444 | doi=10.1056/NEJMsa064964 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17259444 }} </ref> | ||
! rowspan="2"|Trial!!rowspan="2"| Hospitals!!rowspan="2"| Intervention!!rowspan="2"|Comparison !!rowspan="2"|Outcome!!colspan="2"|Results!!rowspan="2"|Comment | ! rowspan="2"|Trial!!rowspan="2"| Hospitals!!rowspan="2"| Intervention!!rowspan="2"|Comparison !!rowspan="2"|Outcome!!colspan="2"|Results!!rowspan="2"|Comment | ||
|-<br/> | |-<br/> | ||
! Intervention!!Control | ! Intervention!!Control | ||
|- | |- | ||
| Sutton et al<ref name=" | | Sutton et al<ref name="pmid23134382"/><br/>2012 ||24 English hospitals compared to 132 control hospitals <br/>U.K.||Bonuses averaged $312,000<br/>"hospital leadership agreed to invest awarded money internally toward efforts to improve clinical care"<br/>U.K.||No intervention|| 30-day in-hospital mortality for patients admitted for [[pneumonia]], [[heart failure]], or acute [[myocardial infarction]]|| Baseline: 20.9%<br/>Follow-up: 20.1%|| Baseline: 13.1%<br/>Follow-up: 12.1%|| Hospitals included in the program had higher baseline mortality. | ||
|- | |- | ||
| HQID<ref name="pmid17259444"/><ref name="pmid22455751"/><br/>2007 || 207 hospitals that voluntarily participated in the HQID project among 613 hospitals that voluntarily participated in a CMS Hospital Quality Alliance (HQA)project for public reporting of outcomes<br/>U.S.A.||Bonuses that averaged $71,960 per year per hospital (for two years)||No intervention|| 30-day mortality after 6 years for admitted for [[pneumonia]], [[heart failure]], acute [[myocardial infarction]] or [[coronary artery bypass]]|| 11.8%|| 11.6%|| | | HQID<ref name="pmid17259444"/><ref name="pmid22455751"/><br/>2007 || 207 hospitals that voluntarily participated in the HQID project among 613 hospitals that voluntarily participated in a CMS Hospital Quality Alliance (HQA)project for public reporting of outcomes<br/>U.S.A.||Bonuses that averaged $71,960 per year per hospital (for two years)||No intervention|| 30-day mortality after 6 years for admitted for [[pneumonia]], [[heart failure]], acute [[myocardial infarction]] or [[coronary artery bypass]]|| 11.8%|| 11.6%|| | ||
Latest revision as of 12:45, 16 September 2020
In health care delivery, pay for performance, also called incentive reimbursement, is "a scheme which provides reimbursement for the health services rendered, generally by an institution, and which provides added financial rewards if certain conditions are met. Such a scheme is intended to promote and reward increased efficiency and cost containment, with better care, or at least without adverse effect on the quality of the care rendered."[1]
Pay for performance is an important component of health care reform.
Studies of effectiveness
Controlled studies show conflicting results.[2][3][4][5]
| Trial | Hospitals | Intervention | Comparison | Outcome | Results | Comment | |
|---|---|---|---|---|---|---|---|
| Intervention | Control | ||||||
| Sutton et al[2] 2012 |
24 English hospitals compared to 132 control hospitals U.K. |
Bonuses averaged $312,000 "hospital leadership agreed to invest awarded money internally toward efforts to improve clinical care" U.K. |
No intervention | 30-day in-hospital mortality for patients admitted for pneumonia, heart failure, or acute myocardial infarction | Baseline: 20.9% Follow-up: 20.1% |
Baseline: 13.1% Follow-up: 12.1% |
Hospitals included in the program had higher baseline mortality. |
| HQID[3][4] 2007 |
207 hospitals that voluntarily participated in the HQID project among 613 hospitals that voluntarily participated in a CMS Hospital Quality Alliance (HQA)project for public reporting of outcomes U.S.A. |
Bonuses that averaged $71,960 per year per hospital (for two years) | No intervention | 30-day mortality after 6 years for admitted for pneumonia, heart failure, acute myocardial infarction or coronary artery bypass | 11.8% | 11.6% | |
References
- ↑ Anonymous (2024), Pay for performance (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 2.2 Sutton M, Nikolova S, Boaden R, Lester H, McDonald R, Roland M (2012). "Reduced mortality with hospital pay for performance in England.". N Engl J Med 367 (19): 1821-8. DOI:10.1056/NEJMsa1114951. PMID 23134382. Research Blogging.
- ↑ 3.0 3.1 3.2 Lindenauer PK, Remus D, Roman S, Rothberg MB, Benjamin EM, Ma A et al. (2007). "Public reporting and pay for performance in hospital quality improvement.". N Engl J Med 356 (5): 486-96. DOI:10.1056/NEJMsa064964. PMID 17259444. Research Blogging.
- ↑ 4.0 4.1 Jha AK, Joynt KE, Orav EJ, Epstein AM (2012). "The long-term effect of premier pay for performance on patient outcomes.". N Engl J Med 366 (17): 1606-15. DOI:10.1056/NEJMsa1112351. PMID 22455751. Research Blogging.
- ↑ Scott A, Sivey P, Ait Ouakrim D, Willenberg L, Naccarella L, Furler J et al. (2011). "The effect of financial incentives on the quality of health care provided by primary care physicians.". Cochrane Database Syst Rev (9): CD008451. DOI:10.1002/14651858.CD008451.pub2. PMID 21901722. Research Blogging.