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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]
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.
Performance is an abstract concept and must be represented by concrete, measurable goals or objectives. For example, baseball athlete performance is abstract as it covers many different types of activities. Batting average is a concrete measure of a particular performance attribute for a particular game role, batting, for the game of baseball.
The five control knobs for health-sector reform. In "Getting Health Reform Right: A Guide to Improving Performance and Equity," [2] Marc Roberts, William Hsiao, Peter Berman, and Michael Reich of the Harvard T.H. Chan School of Public Health aim to provide decision-makers with tools and frameworks for health care system reform.
The standards define the aspect of care to be measured, and should always be based on the best available evidence. A criterion is a measurable outcome of care, aspect of practice or capacity. For example, 'parents / carers are involved in negotiating or planning their child's care'.
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 ...
Health workforce planning is essential for ensuring that health systems possess the appropriate number of skilled workers in suitable locations at optimal times to address care demands.The International Council of Nurses states that Health Human Resources Planning (HHRP) aims to synchronize the number of healthcare professionals with the ...
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...