How Financial and Reputational Incentives Can Be Used to Improve Medical Care
| Autor: | M.B.A. R. Adams Dudley M.D., D M Martin Roland |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Quality management
Quality Assurance Health Care Policy and Administration Payment system report cards Behavioral economics Clinical Research quality of care Physicians Health care Behavioral and Social Science Incentives for Physicians Humans Incentives in health care Reimbursement Incentive Motivation Actuarial science Capitation business.industry Unintended consequences Salaries and Fringe Benefits Health Policy Health services research Fee-for-Service Plans Quality Improvement Reimbursement Health Care Incentive Generic Health Relevance Health Policy & Services Public Health and Health Services Health Services Research business Quality Assurance |
| Zdroj: | Health Services Research Roland, M; & Dudley, RA. (2015). How Financial and Reputational Incentives Can Be Used to Improve Medical Care. Health Services Research, 50, 2090-2115. doi: 10.1111/1475-6773.12419. UC San Francisco: Retrieved from: http://www.escholarship.org/uc/item/84t3q995 Health services research, vol 50 Suppl 2, iss S2 |
| ISSN: | 1475-6773 0017-9124 |
| Popis: | © Health Research and Educational Trust. Objectives. Narrative review of the impact of pay-for-performance (P4P) and public reporting (PR) on health care outcomes, including spillover effects and impact on disparities. Principal Findings. The impact of P4P and PR is dependent on the underlying payment system (fee-for-service, salary, capitation) into which these schemes are introduced. Both have the potential to improve care, but they can also have substantial unintended consequences. Evidence from the behavioral economics literature suggests that individual physicians will vary in how they respond to incentives. We also discuss issues to be considered when including patient-reported outcome measures (PROMs) or patient-reported experience measures into P4P and PR schemes. Conclusion. We provide guidance to payers and policy makers on the design of P4P and PR programs so as to maximize their benefits and minimize their unintended consequences. These include involving clinicians in the design of the program, taking into account the payment system into which new incentives are introduced, designing the structure of reward programs to maximize the likelihood of intended outcomes and minimize the likelihood of unintended consequences, designing schemes that minimize the risk of increasing disparities, providing stability of incentives over some years, and including outcomes that are relevant to patients' priorities. In addition, because of the limitations of PR and P4P as effective interventions in their own right, it is important that they are combined with other policies and interventions intended to improve quality to maximize their likely impact. |
| Databáze: | OpenAIRE |
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