Quality of Services and Information

An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. Acknowledgements

We gratefully acknowledge the sponsors of the pay-for-performance programs and the hospitals, hospital associations, and data vendors whose people willingly made the time to participate in individual discussions with us. They offered us valuable information and insights about their experiences in designing and implementing pay-for-reporting and pa

An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. Program Implementation Challenges

The environmental scan also uncovered a number of program implementation challenges that warrant consideration during program design and implementation.

An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. Design Lessons

Discussions with program sponsors, hospitals, and data vendors revealed the following lessons about P4P program design and operation:

An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. Findings from the Key Informant Discussions

An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. Theoretical Literature and Implications for P4P Design

P4P is common in industries other than health care, and economists and management experts have studied and developed theories on how individuals respond to financial incentives. The economic and management theories that we reviewed suggest that the way in which P4P incentives are structured, or framed, could influence whether they achieve the de

An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. The Empirical Literature on Hospital P4P

As of June 2007, few peer-reviewed studies existed on the use of financial incentives and their impact on quality, patient experience, safety, or the efficient use of resources.

An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. Findings from the Literature Review

An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. An Environmental Scan of Hospital Pay for Performance

The DRA required the Secretary of the DHHS to consider the following design elements when developing the VBP plan: (1) the process for developing, selecting, and modifying measures of quality and efficiency; (2) the reporting, collection, and validation of quality data; (3) the structure, size, and source of value-based payment adjustments; and (4

An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. Summary

Mounting cost pressures and substantial deficits in the quality of care within the U.S.

An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. Preface

In recent years, pay-for-performance (P4P) programs have emerged as a strategy for driving improvements in the quality, safety, and efficiency of delivered health care. In 2005, with passage of the Deficit Reduction Act, Congress mandated that the Secretary of the Department of Health and Human Services (DHHS) develop a plan for value-based purcha

An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report

Prepared by: RAND Health working paper series CHERYL L.DAMBERG, MELONY SORBERO, ATEEV MEHROTRA, STEPHANIE TELEKI, SUSAN LOVEJOY, AND LILY BRADLEY Prepared for: Office of the Assistant Secretary for Planning and Evaluation (ASPE) U.S. Department of Health and Human Services (HHS) Prepared Under: WR-474-ASPE/CMS

PayPerform07.pdf
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Consumer Protection in Private Health Insurance: The Role of Consumer Complaints. Appendix 5 - References

Bodenheimer T “California’s Beleaguered Physician Groups – Will they survive?” New England Journal of Medicine , 2000, 342(14):1064-1068 Brewster LR, Jackson L and CS Lesser “Insolvency and Challenges of Regulating Providers that Bear Risk”, Issues Brief , Center for Studying Health System Change, February 2000, Number 26 Gorml

Consumer Protection in Private Health Insurance: The Role of Consumer Complaints. Appendix 4 - List of NAIC and State Attachments

Attachments - NAIC 1. National Association of Insurance Commissioners, Consumer Complaint White Paper , Draft of 13 March 2000 Attachments – California

Consumer Protection in Private Health Insurance: The Role of Consumer Complaints. Appendix 3 - Interview Questionnaire Employers

1. Do you get involved when your employees have a specific complaint about a health plan, as distinct from general information inquiries about benefit coverage or eligibility? 2. What is the nature of your involvement in employee complaints about health plans? Do you ring, write or fax the health plan? Is there a nominated contact in the health

Consumer Protection in Private Health Insurance: The Role of Consumer Complaints. 3. Complaints Analysis and Agency Performance Issues

Internal use by agency:

Consumer Protection in Private Health Insurance: The Role of Consumer Complaints. 2. Public Education on Complaints

General education/outreach:

Consumer Protection in Private Health Insurance: The Role of Consumer Complaints. 1. Co-Ordination and Liaison

Jurisdiction and relationship with other government agencies:

Consumer Protection in Private Health Insurance: The Role of Consumer Complaints. Appendix 2 - Interview Questionnaire State Officials

Consumer Protection in Private Health Insurance: The Role of Consumer Complaints. Appendix 1 - List of Interviewees

California Judy Penman Supervisor Hotline Consumer Communications Bureau California Department of Insurance Phone: (213) 346-6817 Peter Lee Executive Director Center for Health Care Rights Phone: (213) 383-4519 Maryland

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