Pay-for-Performance

Pay-for-Performance is intended to give monetary incentives to practices for implementing changes that meet systemic healthcare improvement goals. They cover process, outcomes, patient experience and structure measures. The funding source can be private-sector or public-sector initiatives. Consider meeting these reporting needs with data that is collected in a screening protocol as part of normal operations.

Process Measures

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Process measures assess the performance of activities that have been demonstrated to contribute to positive health outcomes for patients. Where this crosses over into screening is primarily around behavioral health issues where detection and follow up can be supported.

 

Outcomes

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Outcome measures refer to the effects that care had on patients. As practices come around the bio-psycho-social model and IBH, it becomes clear that outcomes and treatment needs to be extended beyond simply prescribing and monitoring. Screening being central to IBH supports performance of outcomes measures both directly and indirectly.

 

Patient Experience Measures

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Patient experience measures assess patients’ perception of the quality of care they have received and their satisfaction with the care experience. Patient centered care and getting patient input directly through screening is center to meeting these performance measures.

 

Private-Sector Initiatives

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These program promote quality improvement, accountability, and affordability in health care. For example, the California Pay for Performance Program is the largest physician incentive program in the United States. It focuses on measures related to improving quality performance by physician groups and is transitioning to include value-based cost measures.

 

Public-Sector Initiatives

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In the public sector, the Centers for Medicare and Medicaid Services (CMS) has established a Value-Based Purchasing Program to provide incentives for physicians and providers to improve the quality and efficiency of care. CMS has also been involved in a number of pay-for-performance demonstration projects testing a variety of approaches among different categories of providers.