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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 ...
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 ...
The surveys are free to anyone who wants to use them. They focus on aspects of healthcare quality that patients find important and are well-equipped to assess, such as the communication skills of providers and ease of access to healthcare services. [2] To customize a standardized CAHPS survey, users can add questions on a variety of topics.
This cycle can take anywhere from a few days to several months, often requiring multiple interactions before achieving resolution. [13] The relationship between healthcare providers and insurance companies resembles that of a vendor and subcontractor: healthcare providers contract with insurers to deliver services to covered patients.
PBCs delineate outcome performance goals, ensure that responsibilities are assigned, provide incentives for attaining these goals, and facilitate the overall life-cycle management of system reliability, supportability, and total ownership costs. PBC and PbR instruments have three key features: Payments for pre-agreed results
Health care ratings are ratings or evaluations of health care. In the United States they have been an increasingly used tool to try to drive accountability among health care providers and in the context of classic supply / demand view of Health economics , to help health care consumers make better choices.
The generic model used in the United States is the chronic care model, which holds that health care does not only involve change in the patient and that high-quality disease care counts the community, the health system, self-management support, delivery system design, decision support, and clinical information systems as important elements in ...