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Pay for performance systems link compensation to measures of work quality or goals. Current methods of healthcare payment may actually reward less-safe care, since some insurance companies will not pay for new practices to reduce errors, while physicians and hospitals can bill for additional services that are needed when patients are injured by mistakes. [1]
In 2006 the Tax Relief and Health Care Act (TRHCA) included a provision for a 1.5% incentive payment to eligible providers who successfully submitted quality data to CMS. This provision included a cap on payments. The 2007 Medicare, Medicaid, and SCHIP Extension Act extended the program through 2008 and 2009. It also removed the TRHCA payment cap.
Launched in October 2003, the Hospital Quality Incentive Demonstration (HQID) pay-for-performance project was designed to determine if economic incentives to hospitals were effective at improving the quality of inpatient care.
CMS updates benchmarks by the projected absolute amount of growth in national per capita expenditures as well as by beneficiary characteristics. CMS also establishes a minimum savings rate (MSR) that is calculated as a percentage of the benchmark (2%) that ACO savings must exceed in order to qualify for shared savings.
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In some studies, attainment of HEDIS measures is associated with cost-effective practices or with better health outcomes. In a 2002 study, HEDIS measures "generally reflect[ed] cost-effective practices". [11] A 2003 study of Medicare managed care plans determined that plan-level health outcomes were associated with HEDIS measures. [12]
Pay for performance (human resources), a system of employee payment in the United States that links compensation to measures of work quality or goals; Pay for performance (healthcare), an emerging movement in health insurance in Britain and the United States, in which providers are rewarded for quality of healthcare system; Pay-for-Performance ...
Image source: The Motley Fool. HCA Healthcare (NYSE: HCA) Q4 2024 Earnings Call Jan 24, 2025, 10:00 a.m. ET. Contents: Prepared Remarks. Questions and Answers. Call ...