Originally called the Physician Quality Reporting Initiative, or PQRI, the Physician Quality Reporting System started in 2007, and offered financial incentives for early adopters to participate. As of 2013, 139 quality measures and 22 measure groups were reportable to CMS by physicians and other caregivers in hospitals or physician practices. The program is intended to reward eligible professionals for improving patient care through evidence-based measures, while preparing them for future reporting-based pay-for-performance programs. One of the P4P programs to come out of the Affordable Care Act is the Physician Quality Reporting System, which rewards healthcare professionals for voluntarily reporting on quality care measures. Early feedback shows that such programs can help change behaviors. Successful programs send actionable and timely patient follow-up results to providers, offer incentives for providers to adopt health information technology, and encourage providers to participate in continuous quality improvement practices. P4P programs measure clinical quality and safety, efficiency, patient experience and health information technology adoption. Currently, 180 different P4P programs exist worldwide, with physician-focused programs outnumbering hospital programs four to one. Two of the main sponsors of P4P programs are government agencies and health insurance plans. These programs reward hospitals, physician practices and other providers based on their performance and reporting of select measures. Many believe “pay-for-performance” initiatives will help providers attain the Triple Aim. Providers will be incentivized for engaging in their patients’ care, keeping them healthy, and reducing the utilization of hospitals and emergency departments. To meet this goal, physicians need more efficient and cost-effective ways to care for their patients, avoiding unnecessary tests or procedures. The final goal of the Triple Aim is lowering per capita healthcare costs, measured as a total cost per member (or citizen) per month. Providers look at six measurements: Was care safe, effective, timely, patient-centered, equitable or fair, and efficient? The second element of the Triple Aim is an improved experience of care on the patient’s part. Population health management tends to focus on high-risk patients, because they generate the majority of health costs. They can do so by supplying preventive and chronic care to all their patients, and educating their population on how to support and manage their own healthcare needs during and between visits to their facility. Population health management calls for providers to keep a patient population as healthy as possible, minimizing the need for expensive emergency department visits, hospitalizations, tests, and procedures. The Triple Aim is a framework for optimizing health system performance by focusing on 1) the health of a population, 2) the experience of care for individuals within that population, and 3) the per capita cost of providing that care. Today, the organization remains committed to improving healthcare. Founded in 1980, the IHI initially focused on healthcare best practices and reducing defects and errors in specific areas, such as the emergency department or ICU. The Triple Aim was introduced in 2007 by the Institute for Healthcare Improvement. This is part of an ongoing series designed to help Repertoire readers understand the implications of reform.Īs healthcare continues to move away from fee-for-service medicine in favor of outcomes-based medicine, providers will shift their goals to align with a new initiative – the Triple Aim of Healthcare. Supplier success in a post‐reform healthcare market depends on many factors, including a fundamental and thorough understanding of the foundation of healthcare reform. Pay-for-performance programs are intended to improve population health and the patient experience, while reducing cost
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |