메뉴 건너뛰기




Volumn 133, Issue 22, 2016, Pages 2197-2205

Current state of value-based purchasing programs

Author keywords

costs and cost analysis; outcome assessment (health care); reimbursement mechanisms; value based purchasing

Indexed keywords

ACCOUNTABLE CARE ORGANIZATION; ARTICLE; DRUG SURVEILLANCE PROGRAM; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; HEALTH DISPARITY; HOSPITAL; HOSPITAL PATIENT; HOSPITAL PURCHASING; MEASUREMENT; MEDICARE; OUTCOME ASSESSMENT; OUTPATIENT; PERFORMANCE; PHYSICIAN; PRIORITY JOURNAL; ECONOMICS; HUMAN; PROSPECTIVE PAYMENT; PURCHASING; REIMBURSEMENT; STANDARDS; TRENDS; UNITED STATES;

EID: 84973344385     PISSN: 00097322     EISSN: 15244539     Source Type: Journal    
DOI: 10.1161/CIRCULATIONAHA.115.010268     Document Type: Article
Times cited : (140)

References (56)
  • 1
    • 84978951174 scopus 로고    scopus 로고
    • Centers for Medicare & Medicaid Services Published July 28, 2015. Accessed August 27
    • Centers for Medicare & Medicaid Services NHE-Fact-Sheet. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet.html. Published July 28, 2015. Accessed August 27, 2015
    • (2015) NHE-Fact-Sheet
  • 2
    • 84973314184 scopus 로고    scopus 로고
    • Mirror, mirror on the wall, 2014 update: How the u.s health care system compares internationally
    • Accessed August 27, 2015
    • Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally. Commonwealth Fund June 2014. http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror. Accessed August 27, 2015
    • (2014) Commonwealth Fund
  • 3
    • 80051767654 scopus 로고    scopus 로고
    • The U.S health system in perspective: A comparison of twelve industrialized nations
    • Accessed August 27, 2015
    • Squires D, The U.S. health system in perspective: a comparison of twelve industrialized nations. Commonwealth Fund. July 2011. http://www.commonwealthfund.org/publications/issue-briefs/2011/jul/us-health-system-in-perspective. Accessed August 27, 2015
    • (2011) Commonwealth Fund
    • Squires, D.1
  • 4
    • 84924128998 scopus 로고    scopus 로고
    • Setting value-based payment goals-HHS efforts to improve U.S. Health care
    • Burwell SM, Setting value-based payment goals-HHS efforts to improve U.S. health care. N Engl J Med 2015 372 897 899. doi: 10.1056/NEJMp1500445
    • (2015) N Engl J Med , vol.372 , pp. 897-899
    • Burwell, S.M.1
  • 5
    • 84973356568 scopus 로고    scopus 로고
    • Centers for Medicare & Medicaid Services Published October 15, 2015. Accessed October 15
    • Centers for Medicare & Medicaid Services MACRA: MIPS & APMs. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html. Published October 15, 2015. Accessed October 15, 2015
    • (2015) MACRA: MIPS & APMs
  • 7
    • 78650589643 scopus 로고    scopus 로고
    • What is value in health care?
    • Porter ME, What is value in health care? N Engl J Med 2010 363 2477 2481. doi: 10.1056/NEJMp1011024
    • (2010) N Engl J Med , vol.363 , pp. 2477-2481
    • Porter, M.E.1
  • 8
    • 84939535193 scopus 로고    scopus 로고
    • Accountable care organizations: Ensuring focus on cardiovascular health
    • Patel KK, Cigarroa JE, Nadel J, Cohen DJ, Stecker EC, Accountable care organizations: ensuring focus on cardiovascular health. Circulation 2015 132 603 610. doi: 10.1161/CIRCULATIONAHA.114.010269
    • (2015) Circulation , vol.132 , pp. 603-610
    • Patel, K.K.1    Cigarroa, J.E.2    Nadel, J.3    Cohen, D.J.4    Stecker, E.C.5
  • 9
    • 84936109277 scopus 로고    scopus 로고
    • Will bundled payments change health care? Examining the evidence thus far in cardiovascular care
    • Shih T, Chen LM, Nallamothu BK, Will bundled payments change health care? Examining the evidence thus far in cardiovascular care. Circulation 2015 131 2151 2158. doi: 10.1161/CIRCULATIONAHA.114.010393
    • (2015) Circulation , vol.131 , pp. 2151-2158
    • Shih, T.1    Chen, L.M.2    Nallamothu, B.K.3
  • 11
    • 77956575159 scopus 로고    scopus 로고
    • Improving evaluations of value-based purchasing programs
    • McHugh M, Joshi M, Improving evaluations of value-based purchasing programs. Health Serv Res 2010 45 5 pt 2 1559 1569. doi: 10.1111/j.1475-6773.2010.01147.x
    • (2010) Health Serv Res , vol.45 , Issue.5 PT2 , pp. 1559-1569
    • McHugh, M.1    Joshi, M.2
  • 12
    • 84871856379 scopus 로고    scopus 로고
    • A framework for evaluating the formation, implementation, and performance of accountable care organizations
    • Fisher ES, Shortell SM, Kreindler SA, Van Citters AD, Larson BK, A framework for evaluating the formation, implementation, and performance of accountable care organizations. Health Aff (Millwood) 2012 31 2368 2378. doi: 10.1377/hlthaff.2012.0544
    • (2012) Health Aff (Millwood , vol.31 , pp. 2368-2378
    • Fisher, E.S.1    Shortell, S.M.2    Kreindler, S.A.3    Van Citters, A.D.4    Larson, B.K.5
  • 13
    • 84973356561 scopus 로고    scopus 로고
    • Theory and reality of value-based purchasing: Lessons from the pioneer
    • Published November 1, 1997. Accessed August 27
    • Theory and Reality of Value-Based Purchasing: Lessons from the Pioneer. Agency for Healthcare Research and Quality. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/meyer/index.html. Published November 1, 1997. Accessed August 27, 2015
    • (2015) Agency for Healthcare Research and Quality
  • 14
    • 77955042707 scopus 로고    scopus 로고
    • Hospital performance, the local economy, and the local workforce: Findings from a us national longitudinal study
    • Blustein J, Borden WB, Valentine M, Hospital performance, the local economy, and the local workforce: findings from a US National Longitudinal Study. PLoS Med 2010 7 e1000297. doi: 10.1371/journal.pmed.1000297
    • (2010) Plos Med , vol.7 , pp. e1000297
    • Blustein, J.1    Borden, W.B.2    Valentine, M.3
  • 15
    • 84860858415 scopus 로고    scopus 로고
    • Valuing improvement in value-based purchasing
    • Borden WB, Blustein J, Valuing improvement in value-based purchasing. Circ Cardiovasc Qual Outcomes 2012 5 163 170. doi: 10.1161/CIRCOUTCOMES.111.962811
    • (2012) Circ Cardiovasc Qual Outcomes , vol.5 , pp. 163-170
    • Borden, W.B.1    Blustein, J.2
  • 16
    • 84973296575 scopus 로고    scopus 로고
    • Integrated Healthcare Association Accessed March 30 2016
    • Integrated Healthcare Association Factsheet: Value Based Pay for Performance in California. 2015. http://www.iha.org/sites/default/files/resources/vbp4p-fact-sheet-final-20150925.pdf. Accessed March 30, 2016
    • (2015) Factsheet: Value Based Pay for Performance in California
  • 17
    • 84973296583 scopus 로고    scopus 로고
    • Value based pay for performance in California
    • Brief 8
    • Yegian J, Yanagihara D, Value based pay for performance in California. Integr Healthc Assoc 2013. (Issue Brief No. 8
    • (2013) Integr Healthc Assoc
    • Yegian, J.1    Yanagihara, D.2
  • 19
    • 84973296573 scopus 로고    scopus 로고
    • Pay-for-performance in state Medicaid programs: A survey of state Medicaid directors and programs
    • Accessed September 19, 2015
    • Hartman T, Kukmerker K, Pay-for-performance in state Medicaid programs: a survey of state Medicaid directors and programs. Commonwealth Fund. April 2007. http://www.commonwealthfund.org/publications/fund-reports/2007/apr/pay-for-performance-in-state-medicaid-programs-a-survey-of-state-medicaid-directors-and-programs. Accessed September 19, 2015
    • (2007) Commonwealth Fund
    • Hartman, T.1    Kukmerker, K.2
  • 20
    • 84857799243 scopus 로고    scopus 로고
    • Centers for Medicare & Medicaid Services Published June 12, 2015. Accessed August 28
    • Centers for Medicare & Medicaid Services Overview-Physician Quality Reporting System. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/. Published June 12, 2015. Accessed August 28, 2015
    • (2015) Overview - Physician Quality Reporting System
  • 21
    • 84929174730 scopus 로고    scopus 로고
    • Centers for Medicare & Medicaid Services Published August 4, 2015. Accessed August 28
    • Centers for Medicare & Medicaid Services Value Based Payment Modifier. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/ValueBasedPaymentModifier.html. Published August 4, 2015. Accessed August 28, 2015
    • (2015) Value Based Payment Modifier
  • 23
    • 63849165278 scopus 로고    scopus 로고
    • Centers for Medicare & Medicaid Services Published January 9, 2013. Accessed August 28
    • Centers for Medicare & Medicaid Services Premier Hospital Quality Incentive Demonstration. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalPremier.html. Published January 9, 2013. Accessed August 28, 2015
    • (2015) Premier Hospital Quality Incentive Demonstration
  • 26
    • 65749114697 scopus 로고    scopus 로고
    • Effects of the premier hospital quality incentive demonstration on medicare patient mortality and cost
    • Ryan AM, Effects of the Premier Hospital Quality Incentive Demonstration on Medicare patient mortality and cost. Health Serv Res 2009 44 821 842. doi: 10.1111/j.1475-6773.2009.00956.x
    • (2009) Health Serv Res , vol.44 , pp. 821-842
    • Ryan, A.M.1
  • 27
    • 84860158815 scopus 로고    scopus 로고
    • Medicare's flagship test of pay-for-performance did not spur more rapid quality improvement among low-performing hospitals
    • Ryan AM, Blustein J, Casalino LP, Medicare's flagship test of pay-for-performance did not spur more rapid quality improvement among low-performing hospitals. Health Aff (Millwood) 2012 31 797 805. doi: 10.1377/hlthaff.2011.0626
    • (2012) Health Aff (Millwood , vol.31 , pp. 797-805
    • Ryan, A.M.1    Blustein, J.2    Casalino, L.P.3
  • 28
    • 79955444854 scopus 로고    scopus 로고
    • The effect of pay-for-performance in hospitals: Lessons for quality improvement
    • Werner RM, Kolstad JT, Stuart EA, Polsky D, The effect of pay-for-performance in hospitals: lessons for quality improvement. Health Aff (Millwood) 2011 30 690 698. doi: 10.1377/hlthaff.2010.1277
    • (2011) Health Aff (Millwood , vol.30 , pp. 690-698
    • Werner, R.M.1    Kolstad, J.T.2    Stuart, E.A.3    Polsky, D.4
  • 29
    • 84860116634 scopus 로고    scopus 로고
    • The long-term effect of premier pay for performance on patient outcomes
    • Jha AK, Joynt KE, Orav EJ, Epstein AM, The long-term effect of premier pay for performance on patient outcomes. N Engl J Med 2012 366 1606 1615. doi: 10.1056/NEJMsa1112351
    • (2012) N Engl J Med , vol.366 , pp. 1606-1615
    • Jha, A.K.1    Joynt, K.E.2    Orav, E.J.3    Epstein, A.M.4
  • 30
    • 84871864519 scopus 로고    scopus 로고
    • Hospital pay-for-performance programs in Maryland produced strong results, including reduced hospital-acquired conditions
    • Calikoglu S, Murray R, Feeney D, Hospital pay-for-performance programs in Maryland produced strong results, including reduced hospital-acquired conditions. Health Aff (Millwood) 2012 31 2649 2658. doi: 10.1377/hlthaff.2012.0357
    • (2012) Health Aff (Millwood , vol.31 , pp. 2649-2658
    • Calikoglu, S.1    Murray, R.2    Feeney, D.3
  • 31
    • 84858439975 scopus 로고    scopus 로고
    • Centers for Medicare & Medicaid Services
    • Centers for Medicare & Medicaid Services Hospital Inpatient Quality Reporting Program. https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/hospitalqualityinits/hospitalrhqdapu.html
    • Hospital Inpatient Quality Reporting Program
  • 32
    • 84946545928 scopus 로고    scopus 로고
    • Centers for Medicare & Medicaid Services
    • Centers for Medicare & Medicaid Services Frequently Asked Questions Hospital Value-Based Purchasing Program. Last Updated March 9, 2012. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/hospital-value-based-purchasing/Downloads/FY-2013-Program-Frequently-Asked-Questions-about-Hospital-VBP-3-9-12.pdf
    • (2012) Frequently Asked Questions Hospital Value-Based Purchasing Program
  • 33
    • 84876263221 scopus 로고    scopus 로고
    • Centers for Medicare & Medicaid Services
    • Centers for Medicare & Medicaid Services Hospital Value-Based Purchasing Program. March 2013. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/Hospital-VBPurchasing-Fact-Sheet-ICN907664.pdf
    • (2013) Hospital Value-Based Purchasing Program
  • 35
    • 84973296563 scopus 로고    scopus 로고
    • Centers for Medicare & Medicaid Services Published October 26, 2015. Accessed March 31
    • Centers for Medicare & Medicaid Services Fiscal Year (FY) 2016 Results for the CMS Hospital Value-Based Purchasing Program. https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-10-26.html. Published October 26, 2015. Accessed March 31, 2016
    • (2016) Fiscal Year (FY) 2016 Results for the CMS Hospital Value-Based Purchasing Program
  • 36
    • 84921872189 scopus 로고    scopus 로고
    • The early effects of Medicare's mandatory hospital pay-for-performance program
    • Ryan AM, Burgess JF, Pesko MF, Borden WB, Dimick JB, The early effects of Medicare's mandatory hospital pay-for-performance program. Health Serv Res 2015 50 81 97. doi: 10.1111/1475-6773.12206
    • (2015) Health Serv Res , vol.50 , pp. 81-97
    • Ryan, A.M.1    Burgess, J.F.2    Pesko, M.F.3    Borden, W.B.4    Dimick, J.B.5
  • 37
    • 84903163990 scopus 로고    scopus 로고
    • Thomson Paying for performance in health care implications for health system performance and accountability
    • London, UK Open University Press. Accessed August 27, 2015
    • Cashin C, Chi Y-L, Smith P, Borowitz M, Thomson, Paying for performance in health care. Implications for health system performance and accountability. European Observatory on Health Systems and Policies Series. 2014 London, UK Open University Press. http://www.euro.who.int/en/about-us/partners/observatory/publications/studies/paying-for-performance-in-health-care.-implications-for-health-system-performance-and-accountability. Accessed August 27, 2015
    • (2014) European Observatory on Health Systems and Policies Series
    • Cashin, C.1    Chi, Y.-L.2    Smith, P.3    Borowitz, M.4
  • 38
    • 79959507277 scopus 로고    scopus 로고
    • Analysis raises questions on whether pay-for-performance in Medicaid can efficiently reduce racial and ethnic disparities
    • Blustein J, Weissman JS, Ryan AM, Doran T, Hasnain-Wynia R, Analysis raises questions on whether pay-for-performance in Medicaid can efficiently reduce racial and ethnic disparities. Health Aff (Millwood) 2011 30 1165 1175. doi: 10.1377/hlthaff.2010.1022
    • (2011) Health Aff (Millwood , vol.30 , pp. 1165-1175
    • Blustein, J.1    Weissman, J.S.2    Ryan, A.M.3    Doran, T.4    Hasnain-Wynia, R.5
  • 40
  • 43
    • 33845478495 scopus 로고    scopus 로고
    • Relationship between Medicare's hospital compare performance measures and mortality rates
    • Werner RM, Bradlow ET, Relationship between Medicare's hospital compare performance measures and mortality rates. JAMA 2006 296 2694 2702. doi: 10.1001/jama.296.22.2694
    • (2006) JAMA , vol.296 , pp. 2694-2702
    • Werner, R.M.1    Bradlow, E.T.2
  • 44
    • 84950977555 scopus 로고    scopus 로고
    • National Quality Forum Washington, DC National Quality Forum
    • National Quality Forum Risk Adjustment for Socioeconomic Status or Other Sociodemographic Factors 2014 Washington, DC National Quality Forum. http://www.qualityforum.org/Publications/2014/08/Risk-Adjustment-for-Socioeconomic-Status-or-Other-Sociodemographic-Factors.aspx
    • (2014) Risk Adjustment for Socioeconomic Status or Other Sociodemographic Factors
  • 45
    • 0041109884 scopus 로고    scopus 로고
    • Time discounting and time preference: A critical review
    • Frederick S, Loewenstein G, O'Donoghue T, Time discounting and time preference: a critical review. J Econ Lit 2002 40 351 401. doi: 10.1257/002205102320161311
    • (2002) J Econ Lit , vol.40 , pp. 351-401
    • Frederick, S.1    Loewenstein, G.2    O'Donoghue, T.3
  • 46
    • 0001076162 scopus 로고
    • Loss aversion in riskless choice: A reference-dependent model
    • Tversky A, Kahneman D, Loss aversion in riskless choice: a reference-dependent model. Q J Econ 1991 106 1039 1061. doi: 10.2307/2937956
    • (1991) Q J Econ , vol.106 , pp. 1039-1061
    • Tversky, A.1    Kahneman, D.2
  • 47
    • 77955778942 scopus 로고    scopus 로고
    • Systematic review: Effects, design choices, and context of pay-for-performance in health care
    • Herck PV, Smedt DD, Annemans L, Remmen R, Rosenthal MB, Sermeus W, Systematic review: effects, design choices, and context of pay-for-performance in health care. BMC Health Serv Res 2010 10 247. doi: 10.1186/1472-6963-10-247
    • (2010) BMC Health Serv Res , vol.10 , pp. 247
    • Herck, P.V.1    Smedt, D.D.2    Annemans, L.3    Remmen, R.4    Rosenthal, M.B.5    Sermeus, W.6
  • 48
    • 84862578415 scopus 로고    scopus 로고
    • Do physician organizations located in lower socioeconomic status areas score lower on pay-for-performance measures?
    • Chien AT, Wroblewski K, Damberg C, Williams TR, Yanagihara D, Yakunina Y, Casalino LP, Do physician organizations located in lower socioeconomic status areas score lower on pay-for-performance measures? J Gen Intern Med 2012 27 548 554. doi: 10.1007/s11606-011-1946-8
    • (2012) J Gen Intern Med , vol.27 , pp. 548-554
    • Chien, A.T.1    Wroblewski, K.2    Damberg, C.3    Williams, T.R.4    Yanagihara, D.5    Yakunina, Y.6    Casalino, L.P.7
  • 49
    • 84866093354 scopus 로고    scopus 로고
    • Patient experience in safety-net hospitals: Implications for improving care and value-based purchasing
    • Chatterjee P, Joynt KE, Orav EJ, Jha AK, Patient experience in safety-net hospitals: implications for improving care and value-based purchasing. Arch Intern Med 2012 172 1204 1210. doi: 10.1001/archinternmed.2012.3158
    • (2012) Arch Intern Med , vol.172 , pp. 1204-1210
    • Chatterjee, P.1    Joynt, K.E.2    Orav, E.J.3    Jha, A.K.4
  • 50
    • 84866329087 scopus 로고    scopus 로고
    • Based on key measures, care quality for Medicare enrollees at safety-net and non-safety-net hospitals was almost equal
    • Ross JS, Bernheim SM, Lin Z, Drye EE, Chen J, Normand SL, Krumholz HM, Based on key measures, care quality for Medicare enrollees at safety-net and non-safety-net hospitals was almost equal. Health Aff (Millwood) 2012 31 1739 1748. doi: 10.1377/hlthaff.2011.1028
    • (2012) Health Aff (Millwood , vol.31 , pp. 1739-1748
    • Ross, J.S.1    Bernheim, S.M.2    Lin, Z.3    Drye, E.E.4    Chen, J.5    Normand, S.L.6    Krumholz, H.M.7
  • 51
    • 84890895177 scopus 로고    scopus 로고
    • Will value-based purchasing increase disparities in care?
    • Ryan AM, Will value-based purchasing increase disparities in care? N Engl J Med 2013 369 2472 2474. doi: 10.1056/NEJMp1312654
    • (2013) N Engl J Med , vol.369 , pp. 2472-2474
    • Ryan, A.M.1
  • 52
    • 84941660684 scopus 로고    scopus 로고
    • The financial effect of value-based purchasing and the hospital readmissions reduction program on safety-net hospitals in 2014: A cohort study
    • Gilman M, Hockenberry JM, Adams EK, Milstein AS, Wilson IB, Becker ER, The financial effect of value-based purchasing and the hospital readmissions reduction program on safety-net hospitals in 2014: a cohort study. Ann Intern Med 2015 163 427 436. doi: 10.7326/M14-2813
    • (2015) Ann Intern Med , vol.163 , pp. 427-436
    • Gilman, M.1    Hockenberry, J.M.2    Adams, E.K.3    Milstein, A.S.4    Wilson, I.B.5    Becker, E.R.6
  • 53
    • 84906085394 scopus 로고    scopus 로고
    • The intended and unintended consequences of quality improvement interventions for small practices in a community-based electronic health record implementation project
    • Ryan AM, McCullough CM, Shih SC, Wang JJ, Ryan MS, Casalino LP, The intended and unintended consequences of quality improvement interventions for small practices in a community-based electronic health record implementation project. Med Care 2014 52 826 832. doi: 10.1097/MLR.0000000000000186
    • (2014) Med Care , vol.52 , pp. 826-832
    • Ryan, A.M.1    McCullough, C.M.2    Shih, S.C.3    Wang, J.J.4    Ryan, M.S.5    Casalino, L.P.6
  • 56
    • 85001842808 scopus 로고    scopus 로고
    • Medicare program; Medicare shared savings program; Accountable care organizations-revised benchmark rebasing methodology, facilitating transition to performance-based risk, and administrative finality of financial calculations
    • Centers for Medicare & Medicaid Services Accessed March 31, 2016
    • Centers for Medicare & Medicaid Services Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations-Revised Benchmark Rebasing Methodology, Facilitating Transition to Performance-Based Risk, and Administrative Finality of Financial Calculations. Federal Register 2016 81 5824 5872. https://www.federalregister.gov/articles/2016/02/03/2016-01748/medicare-program-medicare-shared-savings-program-accountable-care-organizations-revised-benchmark. Accessed March 31, 2016
    • (2016) Federal Register , vol.81 , pp. 5824-5872


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.