Implications of pay-for-performance on hospital quality indicators: Outcome-based evaluative case study.

摘要

The utilization of an incentive program associated with provider reimbursement has become one of the most popular tools in health care reimbursement. The primary rationale behind a pay-for-performance (P4P) incentive program is to provide a financial incentive to a provider for quality, efficient, and improved care to patients. As popular as these programs are, there has been little research offered to document the effectiveness and whether or not a correlation exists between quality and incentivizing providers. This study was approached from the perspective of evaluating a health care organization's incentive program for hospitals voluntarily participating in the program. The evaluative case study was unique in that it was the first to evaluate the hospital incentive program of an insurance organization and also review the acute care hospitals that participated in the program. The study focused on the southeast region of the United States, specifically the state of Georgia. The purpose of the study was to determine if there was a relationship between quality and pay-for-performance incentives and if those characteristics analyzed could be generalized. The findings of the study were intended to illustrate the effectiveness of the hospital incentive program. While additional research is needed, the case study was able to address all of the concerns raised in the current literature; the analysis was able to answer the question that participation in an incentive program does result in quality improvement and positive patient outcomes.