Research Links on Pay-for-Performance
Agency for Healthcare
Research and Quality
http://www.ahrq.gov/qual/measurix.htm
The Agency for
Healthcare Research and Quality's (AHRQ) mission is to improve
the quality, safety, efficiency, and effectiveness of health care
for
all Americans. Information from AHRQ's research helps people
make more
informed decisions and improve the quality of health care services.
AHRQ was formerly known as the Agency for Health Care Policy
and Research.
American Academy of Family Physicians (AAFP)
http://www.aafp.org/fpm/20040300/45gett.html
Founded in 1947, the American Academy of Family Physicians represents
more than 93,700 physicians and medical students nationwide. It is
the only medical specialty society devoted solely to primary care.
American Medical Association
Pay-for-Performance Guidelines
http://www.ama-assn.org/ama/pub/category/14416.html
On March 2, 2005, the American Medical Association released a new set of pay-for-performance principles and guidelines for the formation and implementation of pay-for-performance programs.
American Medical Association
Physician Consortium for Performance Improvement
http://www.ama-assn.org/ama/pub/category/2946.html
The Physician Consortium for Performance Improvement is a group
of clinical and methodological experts convened by the American Medical
Association (AMA). The Consortium includes representatives
from more than 60 national medical specialty and state medical societies,
the Agency for Healthcare Research and Quality, and the Centers for
Medicare and Medicaid Services.
Bridges to Excellence
http://www.bridgestoexcellence.org
The Bridges to Excellence coalition is a not-for-profit organization
created to encourage diverse significant leaps in the quality of
care by recognizing and rewarding health care providers who demonstrate
that they deliver safe, timely, effective, efficient and patient-centered
care. Bridges to Excellence participants include large employers,
health plans, the National Committee for Quality Assurance, MEDSTAT
and WebMD Health, among others.
Care Focused Purchasing
http://www.mercerhr.com/pressrelease/details.jhtml?idContent=1132360
Care Focused Purchasing (CFP) is a collective initiative that currently
involves 28 large employers covering approximately 2 million employees
and their dependents. The employer group is currently working on
adopting from existing sources a set of standardized performance
measures of quality and efficiency for hospitals and physicians,
sharing provider performance measures with employees and employers
to help them make better informed decisions and creating market
demand for open and accessible information about hospital and physician
performance.
Center for Studying Health System Change
http://www.hschange.org/CONTENT/675/
Growing national attention to improving quality and patient safety
is spurring development of quality-based financial incentives for
physicians and hospitals. Health plans in particular are driving
these pay-for-performance initiatives, according to findings from
the Center for Studying Health System Change's (HSC) 2002-03 site
visits to 12 nationally representative communities.
Doctors' Office Quality - Information Technology (DOQ-IT)
http://www.doqit.org/doqit/jsp/index.jsp
Doctors' Office Quality Information Technology (DOQ-IT) promotes
the adoption of electronic health record (EHR) systems and information
technology (IT) in small-to-medium sized physician offices with
a vision of enhancing access to patient information, decision support,
and reference data, as well as improving patient-clinician communications.
The Centers for Medicare and Medicaid Services (CMS) has awarded
Lumetra the role of lead Quality Improvement Organization (QIO)in
partnership with the American Academy of Family Physicians' (AAFP)
Center for Health Information Technology.
Florida Health Care Coalition
http://www.cfhcc.net/programs/initiatives/quality.html
This coalition represents over one million members from public
and private Florida employers, and has been recognized nationally
for
its quality initiatives. After successfully developing tools to
measure and reward inpatient performance, CFHCC is now creating an
outpatient
model for doctors who make a living in their office.
Integrated Healthcare Association
http://www.iha.org
The Integrated Healthcare Association (IHA) is composed of top
decision-makers from the major health care stakeholder groups in
California. Its
mission is to promote the continuing evolution of integrated health
care, supported by financial mechanisms that align incentives of
purchasers, payors, and providers, as the best means to achieve
positive outcomes for the patient and the general public.
Joint Commission on Accreditation of Healthcare
Organizations
http://www.jcaho.org/news+room/news+release+archives
The Joint
Commission evaluates and accredits nearly 16,000 health care organizations
and programs in the United States. An independent,
not-for-profit organization, the Joint Commission is the nation's
predominant standards-setting and accrediting body in health care.
The organization recently unveiled a set of Principles to guide
the development and refinement of health care pay-for-performance
programs.
Leapfrog Group
http://www.leapfroggroup.org/rewards_compendium
The Leapfrog Group is an initiative driven by organizations that
buy health care who are working to initiate breakthrough improvements
in the safety, quality and affordability of healthcare for Americans.
With support from The Commonwealth Fund and The Robert Wood Johnson
Foundation, the organization has developed the first public Web-based
compendium of incentive and reward programs aimed at improving
health care in both in-patient and out-patient settings.
MN Community Measurement Project
http://www.mnhealthcare.org
MN Community Measurement© is a new nonprofit entity dedicated
to improving the quality of health care in Minnesota. The organization
was formed to improve care and support quality initiatives for providers
throughout the state, reduce reporting-related expenses for medical
groups, health plans and regulators and communicate findings in a
fair, usuable and reliable way. The companies forming MN Community
Measurement were Blue Cross and Blue Shield of Minnesota/Blue Plus,
First Plan of Minnesota, HealthPartners, Medica, Metropolitan Health
Plan, Preferred One and UCare Minnesota. StratisHealth also contributes
data to the initiative.
National Committee for Quality Assurance (NCQA)
http://www.ncqa.org/Programs/PGO/pgoip.htm
The National Committee for Quality Assurance (NCQA) is a premier
source for information about the quality of the nations managed
care plans. NCQA is an independent, 501(c)(3) non-profit organization
whose mission is to improve health care quality everywhere. It is
involved in several P4P initiatives.
National Health Care Purchasing Institute
http://www.nhcpi.net/pdf/models.pdf
The NHCPI was founded to improve health care quality by advancing
the purchasing practices of major corporations and government agencies,
particularly Fortune 500 companies, Medicare, and public employers.
The group has sponsored a report called Provider Incentive
Models for Improving Quality of Care.
National Quality Forum
http://www.qualityforum.org
The National Forum for Health Care Quality Measurement and Reporting
(National Quality Forum or NQF) is a not-for-profit membership
organization created to develop and implement a national strategy
for health care
quality measurement and reporting. A shared sense of urgency about
the impact of health care quality on patient outcomes, workforce
productivity, and health care costs prompted leaders in the public
and private sectors to create the NQF as a mechanism to bring about
national change.
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Pay-for-Performance Literature Review
Arrow KJ (1963). "Uncertainty and the welfare economics of
medical care." Am Econ Rev: 941-973.
Bailit Health Purchasing, L. (2002). Provider incentive models for
improving quality of care. Prepared for the National Health Care
Purchasing Institute: An Initiative of the Robert Wood Johnson Foundation.
Casalino L., R. R. Gillies, et al. (2003). "External incentives,
information technology, and organized processes to improve health
care quality for patients with chronic diseases." Jama 289(4):
434-41.
Epstein, A. M., T. H. Lee, et al. (2004). "Paying physicians
for high-quality care." N Engl J Med 350(4): 406-10.
Fisher E. S., D. E. Wennberg, et al. (2003). "The implications
of regional variations in Medicare spending. Part 1: the content,
quality, and accessibility of care." Ann Intern Med 138(4):
273-87.
Hall, M. A., E. Dugan, et al. (2002). "How disclosing HMO physician
incentives affects trust. Not all cost-minimizing physician incentives
are ethically troubling to patients." Health Aff (Millwood)
21(2): 197-206.
Hofer, T. P., R. A. Hayward, et al. (1999). "The unreliability
of individual physician "report cards" for assessing the
costs and quality of care of a chronic disease." Jama 281(22):
2098-105.
Institute of Medicine (2001). Crossing the quality chasm: a new health
system for the 21st century. Washington, D.C., National Academy Press.
Kralewski, J. E., E. C. Rich, et al. (2000). "The effects of
medical group practice and physician payment methods on costs of
care." Health Serv Res 35(3): 591-613.
McGlynn, E. A., S. M. Asch, et al. (2003). "The quality of health
care delivered to adults in the United States." N Engl J Med
348(26): 2635-45.
Roland, M. (2004). "Linking physicians' pay to the quality of
care--a major experiment in the United kingdom." N Engl J Med
351(14): 1448-54.
Schuster, M. A., E. A. McGlynn, et al. (1998). "How good is
the quality of health care in the United States?" Milbank Q
76(4): 517-63, 509.
Shortell SM (2004). "Increasing value: a research agenda for
addressing the managerial and organizational challenges facing health
care delivery in the United States." Med Care Res Rev 61(3):
12S-30S.
Soumerai, S. B. (2004). "Benefits and risks of increasing restrictions
on access to costly drugs in Medicaid." Health Aff (Millwood)
23(1): 135-46.
Strunk BC, H. R. (2004). Paying for quality: health plans try carrots
instead of sticks. Issue brief: findings from HSC. Washington, D.C.:
1-4.
Town R, K. J., Dowd B (2004). "Assessing the influence of incentives
on physicians and medical groups." Med Care Res Rev 61(3): 80S-118Ss.
Zaslavsky, A. M., J. N. Hochheimer, et al. (2000). "Impact of
sociodemographic case mix on the HEDIS measures of health plan quality." Med
Care 38(10): 981-92.
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