Pay-for-perform (P4P) is not a new term in human resource management or performance management. The US healthcare system has been criticized for high-cost, inefficacy, and issues on quality. P4P is an approach used to provide incentives to physicians and health care provider organizations to achieve improved performance by increasing quality of care or reducing costs (Kongstvedt, 2016). By paying for specified standards of quality care, P4P may help equalize quality among providers within the same healthcare organization, region, and across different regions in the US. P4P can also include explicit incentives for other goals, such as reducing costs or improving coordination of care among providers. So far, P4P program results have not lived up to the original expectations (Markovitz & Ryan, 2017). There is no a perfect system in the worlds; continuous improvement is always needed for everything, including P4P.
As we know, the Patient Protection and Affordable Care Act is a big promoter of P4P. In the past few years, healthcare organizations and providers have striven to reallocate resources and attempt to meet the quality measures set by the Act. This week, I am look forward to seeing great discussion in the DB.
Kongstvedt, P. R. (2016). Health insurance and managed care (4th ed.). Jones and Bartlett Publishers.
Markovitz, A. A., & Ryan, A. M. (2017). Pay-For-Performance: disappointing results or masked heterogeneity? Medical Care Research & Review, 74(1), 3-78.WEEK 3 DISCUSSION INSTRUCTIONS AND RUBRIC
Read the following article:
Health Policy Brief
Discuss the following from the perspective of a provider:
· Define pay for performance and assess its use as a quality measure in managed care systems.
· Provide an example for each of the 4 categories of pay for performance measurement.
· Choose one of the four payment programs in this article and evaluate its use as it relates to pay for performance using one more outside resource in your review.
· Note that there are several resources located in this article reference list that can be expanded on for this assignment.
Justify your responses using examples.
PLEASE GET MOST OF YOUR INFO FROM THE ABOVE AND BELOW WEBSITE
AND THE TEXTBOOK AND CITE ACCORDINGLY.
· To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
· Your initial posting should be addressed at 300-500 words. Submit your document to this Discussion Area by the due date assigned of this Week. Be sure to cite your sources using APA format.
· Respond to your peers throughout the Week. Justify your answers with examples, research, and reasoning. Follow up posts need to be submitted by the end of this Week.
· Use the following rubric as a guide to complete your discussion responses.
Emerging (F-D: 1-27)
Satisfactory (C: 28-31)
Proficient (B: 32-35)
Exemplary (A: 36-40)
Quality of Initial Posting
No initial posting exists to evaluate.
The information provided is inaccurate, not focused on the assignment’s topic, and/or does not answer the question(s) fully. Response demonstrates incomplete understanding of the topic and/or inadequate preparation.
The information provided is accurate, giving a basic understanding of the topic(s) covered. A basic understanding is when you are able to describe the terms and concepts covered. Despite this basic understanding, initial posting may not include complete development of all aspects of the assignment.
The information provided is accurate, displaying a good understanding of the topic(s) covered. A good understanding is when you are able to explain the terms and topics covered. Initial posting demonstrates sincere reflection and addresses most aspects of the assignment, although all concepts may not be fully developed.
The information provided is accurate, providing an in-depth, well thought-out understanding of the topic(s) covered. An in-depth understanding provides an analysis of the information, synthesizing what is learned from the course/assigned readings.
This table lists criteria and criteria group name iMHC6303 QUALITY PERFORMANCE AND MGMT WEEK 3 LECTURE NOTES
A Small Rural Hospital
Bill was the administrator of a small rural hospital located in the upper Midwest. He had been a healthcare manager for over ten years and was accustomed to dealing with all types of problems, ranging from physician complaints to staffing shortages to upset customers. His current problem, however, was different; it was personal. He had to decide whether his wife should deliver their second child at his hospital. It was not an easy decision.
Bill had moved up through the management ranks by working as a business office manager and then a project coordinator at a large medical center. During this time, he had completed his master’s degree in healthcare administration from a distance learning university.
While Bill enjoyed working for a large facility in a big city, he realized it would probably be many years before he was promoted to a senior management position. On the other hand, with his experience and education, it wasn’t long before he was able to land the top position in a small facility, which consisted of a forty-bed acute care hospital and a sixty-bed skilled nursing home.
Three physicians served the community; two were family practitioners, and the third specialized in internal medicine. However, they all functioned as general practitioners, treating what they could and referring more complex care to a larger facility 75 miles away.
This review is about rural healthcare services. While smaller in scale the issues are similar. Next you will look specifically at an example of medical care. Review the following resources for more information on this topic.
Pati, D., Gaines, K., & Valipoor, S. (2016). Delivering rural health in a changing health model. HERD : Health Environments Research & Design Journal, 10(1), 76-86. doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1177/1937586716656
Lee, D. (2012). Implementation of quality programs in health care organizations. Service Business, 6(3), 387-404. doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1007/s11628-012-0141-2
A Good Doctor
One family practitioner, Dr. Able, had been delivering babies ever since he established his practice over twenty-five years ago. Although all three physicians shared calls for other emergency services, only Dr. Able delivered babies. Dr. Able was so committed to his “moms” that he would not take a vacation when someone was due and remained available 24/7 for obstetrical services.
Many people in the community were loyal to Dr. Able and thankful for his services. Others, including many people who did not grow up in the community (like Bill and his wife), were concerned because Dr. Able was not board certified in obstetrics and there was no backup for his services. Bill was under pressure from his mother-in-law, a nurse, who said she didn’t know how Bill could let his child be born in a hospital that did not have a pediatrician available in case
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