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The Demonstration is a prime example of the shared savings model of payment reform [3] and represents Medicare's first physician Pay-for-Performance initiative. [4] The three main goals of the PGP Demonstration are: To encourage physician participation in Parts A & B of the Medicare Program; To promote cost efficiency and quality of care; and
Pay for performance systems link compensation to measures of work quality or goals. Current methods of healthcare payment may actually reward less-safe care, since some insurance companies will not pay for new practices to reduce errors, while physicians and hospitals can bill for additional services that are needed when patients are injured by mistakes. [1]
In 2006 the Tax Relief and Health Care Act (TRHCA) included a provision for a 1.5% incentive payment to eligible providers who successfully submitted quality data to CMS. This provision included a cap on payments. The 2007 Medicare, Medicaid, and SCHIP Extension Act extended the program through 2008 and 2009. It also removed the TRHCA payment cap.
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), (H.R. 2, Pub. L. 114–10 (text)) commonly called the Permanent Doc Fix, is a United States statute. Revising the Balanced Budget Act of 1997, the Bipartisan Act was the largest scale change to the American health care system following the Affordable Care Act in 2010. [1]
Pay-for-Performance is a method of employee motivation meant to improve performance in the United States federal government by offering incentives such as salary increases, bonuses, and benefits. It is a similar concept to Merit Pay for public teachers and it follows basic models from Performance-related Pay in the private sector.
In the United States, Medicare has various pay-for-performance ("P4P") initiatives in offices, clinics and hospitals, seeking to improving quality and avoid unnecessary health care costs. [151] The Centers for Medicare and Medicaid Services (CMS) has several demonstration projects underway offering compensation for improvements:
A 1998 report to the Health Care Financing Administration (now known as the Centers for Medicare and Medicaid Services) noted that in the five years of the demonstration project, the seven hospitals would have had expenditures of $438 million for coronary artery bypasses for Medicare beneficiaries, but the change in reimbursement methodology ...
Pay for performance may refer to: Pay for performance (human resources), a system of employee payment in the United States that links compensation to measures of work quality or goals; Pay for performance (healthcare), an emerging movement in health insurance in Britain and the United States, in which providers are rewarded for quality of ...