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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 ...
Cost-shifting implies price discrimination and price discrimination will be applicable if the pricing system allows it. Of the three conventional pricing models in the health care industry, including individual negotiation, collective negotiation, and unilateral pricing, only price discrimination can be implemented in the individual negotiation ...
Value-based health care (VBHC) is a framework for restructuring health care systems with the overarching goal of value for patients, with value defined as health outcomes per unit of costs. [1] The concept was introduced in 2006 by Michael Porter and Elizabeth Olmsted Teisberg , though implementation efforts on aspects of value-based care began ...
Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. [1]In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care.
HHN (Hospitals & Health Networks) Magazine. Archived from the original on 2011-07-11; Pham HH, Ginsburg PB, Lake TK, Maxfield MM (January 2010). "Episode-based payments: charting a course for health care payment reform" (PDF). Washington, DC: National Institute for Health Care Reform. Archived from the original (PDF) on 2010-08-19
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 Congressional Budget Office analyzed the reasons for healthcare cost inflation over time, reporting in 2008 that: "Although many factors contributed to the growth, most analysts have concluded that the bulk of the long-term rise resulted from the health care system's use of new medical services that were made possible by technological ...
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 ...