Pay-for-performance: The MedPAC perspective

Health Affairs

Volumn 25, Issue 2, 2006, Pages 413-419

  Milgate, Karen ^a   Cheng, Sharon Bee ^a  

^a Medicare Payment Advisory Commission   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AGED; ARTICLE; ECONOMICS; HEALTH CARE FACILITY; HEALTH CARE QUALITY; HUMAN; LEGAL ASPECT; MEDICARE; PROSPECTIVE PAYMENT; REIMBURSEMENT; STANDARD; UNITED STATES;

AGED; HEALTH FACILITIES; HUMANS; MEDICARE; MEDICARE PAYMENT ADVISORY COMMISSION; QUALITY ASSURANCE, HEALTH CARE; REIMBURSEMENT, INCENTIVE; UNITED STATES;

EID: 33645664709     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.25.2.413     Document Type: Article

References (18)

1. Medicare Payment Advisory Commission, Report to the Congress: Variation and Innovation in Medicare (Washington: MedPAC, June 2003), chap. 7.
2. E.A. McGlynn et al., "The Quality of Health Care Delivered to Adults in the United States," New England Journal of Medicine 348, no. 26 (2003): 2635-2645;
3. Institute of Medicine, Crossing the Quality Chasm: A New Health System for the Twenty-first Century (Washington: National Academies Press, 2001);
4. S.F. Jencks, ED. Huff, and T. Cuerdon, "Change in the Quality of Care Delivered to Medicare Beneficiaries, 1998-1999 to 2000-2001," Journal of the American Medical Association 289, no. 3 (2003): 305-312;
5. and MedPAC, Report to the Congress: Medicare Payment Policy (Washington: MedPAC, March 2004), 31-47.
6. MedVantage Inc., "Provider Pay-for-Performance Incentive Programs: 2004 National Study Results," 2005, http://www.medvantage.com/Pdf/ MV_2004_P4P_National_Study_Results-Exec_Summary.pdf (accessed 17 January 2006).
7. S. Alexander, "Clinical Quality Improvement: Strategies to Maximize Reimbursement in Pay for Performance Programs" (Presentation at Institute for Healthcare Improvement National Forum, Orlando, Florida, December 2005).
8. T. Lee, "Paying for Performance in Health Care: Getting a Better Deal" (Presentation at the National Health Policy Forum session, Paying for Performance in Health Care: Getting a Better Deal, Washington, D.C., 9 July 2004).
9. See MedPAC, Report to the Congress: Medicare Payment Policy (March 2004), chaps. 3E and 4;
10. and MedPAC, Report to the Congress: Medicare Payment Policy (Washington: MedPAC, March 2005), chap. 4.
11. A table listing these measures is available in an online appendix, http://content.healthaffairs.org/cgi/content/full/25/2/413/DC1.
12. The CMS has developed a list of thirty-six measures for physicians who treat Medicare beneficiaries and is designing a system to collect information on them from daims data.
13. A table listing these activities is available online; see Note 7.
14. Elizabeth McGlynn, associate director, RAND, personal communication, 4 January 2005.
15. A listing of home health quality measures is available online; see Note 7
16. The monthly capitated rate paid to physicians makes it relatively straightforward to identify the patients and facilities with whom the physician works.
17. E.A. Coleman, "Falling through the Cracks: Challenges and Opportunities for Improving Transitional Care for Persons with Continuous Complex Care Needs," Journal of the American Geriatrics Society 51, no. 4 (2003): 549-555;
18. and R.A. Berenson and J. Horvath, "Confronting the Barriers to Chronic Care Management in Medicare," Health Affairs 22 (2003): w37-w53 (published online 22 January 2003; 10.1377/hlthaff.w3.37).