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In the healthcare industry, pay for performance (P4P), also known as "value-based purchasing", is a payment model that offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures. Clinical outcomes, such as longer survival, are difficult to measure, so pay for ...
Robotic process automation (RPA) is a form of business process automation that is based on software robots (bots) or artificial intelligence (AI) agents. [1] RPA should not be confused with artificial intelligence as it is based on automation technology following a predefined workflow. [ 2 ]
The Healthcare Effectiveness Data and Information Set (HEDIS) is a widely used set of performance measures in the managed care industry, developed and maintained by the National Committee for Quality Assurance (NCQA). HEDIS was designed to allow consumers to compare health plan performance to other plans and to national or regional benchmarks.
An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation. The organization is accountable to ...
According to Dr. Relman, American health care system is a profit-driven industry and it has become a widely accepted theory these days. [10] Since the term was introduced 40 years ago, health care industry has developed into even a larger, greater and flourishing industry.
The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of healthcare databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).
He listed five causes for the waste: (1) overtreatment of patients, (2) the failure to coordinate care, (3) the administrative complexity of the health care system, (4) burdensome rules and (5) fraud. [58] The Institute of Medicine reported in September 2012 that approximately $750B per year in U.S. health care costs are avoidable or wasted ...
Intelligent automation (IA), or intelligent process automation, is a software term that refers to a combination of artificial intelligence (AI) and robotic process automation (RPA). [1] Companies use intelligent automation to cut costs and streamline tasks by using artificial-intelligence-powered robotic software to mitigate repetitive tasks. [ 1 ]