A detailed description and origins of pay for performance
Pay-for-performance initiatives are designed to improve the efficiency, quality and general value of health care. Other terms used to refer to pay-for-performance include pay-for-quality, alternative payment, valued-based payment, among others. No matter the nomenclature, the main objective of pay-for-performance is to improve efficiency for optimal outcomes. (Rosenthal et al., 2005)
During the early 1990s, many consumers opted for managed care by paying some cash to the providers for a particular set of services. Such arrangement led to compromised quality and put some strain on patients.
Come 2000, the US was experiencing serious deficiency in health care quality. The Institute of Medicine wrote a detailed report on this. Thus pay-for-performance became a valid option for quality health care. (Vogenberg & Smart, 2018)
Who is affected by pay-for-performance?
A number of studies have been conducted to evaluate adherence to medication versus medication subsidies, but no valid conclusions have yet been made. Medication adherence was shown to improve with higher drug coverage, reduction of cost-sharing and prescription cap. Poor adherence to medication was observed for patients with full medication subsidies. Such non-detailed conclusions show the need for further studies on factors influencing patients’ adherence to medication. (Rosenthal et.al 2005)
According to Barello et.al (2012), chronic illness patients who are required to pay for their medication are more likely to tone down their use of medication. A study conducted in the US revealed that about 25% of older patients ignore their prescribed medicines due to the high costs.
Public insurers such as Medicare have frequently used pay-for-performance in hospitals. Private health care providers have also used more than forty pay-for-performance programs. However, it is still doubtful whether they improve quality. The few studies which attempt to prove improvement in health care quality...
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