Pay For Performance In Health Care

Health spending continues to grow faster than the economy in most OECD countries. In 2010, the OECD published a study of strategies to increase value for money in health care, in which pay for performance (P4P) was identified as an innovative tool to improve health system efficiency in several OECD countries. However, evidence that P4P increases value for money, boosts quality of processes in health care, or improves health outcomes is limited.This book explores the many questions surrounding P4P such as whether the potential power of P4P has been over-sold, or whether the disappointing results to date are more likely rooted in problems of design and implementation or inadequate monitoring and evaluation. The book also examines the supporting systems and process, in addition to incentives, that are necessary for P4P to improve provider performance and to drive and sustain improvement. The book utilises a substantial set of case studies from 12 OECD countries to shed light on P4P programs in practice.Featuring both high and middle income countries, cases from primary and acute care settings, and a range of both national and pilot programmes, each case study features: Analysis of the design and implementationdecisions, including the role of stakeholders Critical assessment of objectives versus results Examination of the of 'net' impacts, includingpositive spillover effects and unintended consequences The detailed analysis of these 12 case studies together with the rest of this critical text highlight the realities of P4P programs and their potential impact on the performance of health systems in a diversity of settings. As a result, this book provides critical insights into the experience to date with P4P and how this tool may be better leveraged to improve health system performance and accountability. This title is in the European Observatory on Health Systems and Policies Series.

This book provides a balanced assessment of pay for performance (P4P), addressing both its promise and its shortcomings. P4P programs have become widespread in health care in just the past decade and have generated a great deal of enthusiasm in health policy circles and among legislators, despite limited evidence of their effectiveness. On a positive note, this movement has developed and tested many new types of health care payment systems and has stimulated much new thinking about how to improve quality of care and reduce the costs of health care. The current interest in P4P echoes earlier enthusiasms in health policy—such as those for capitation and managed care in the 1990s—that failed to live up to their early promise. The fate of P4P is not yet certain, but we can learn a number of lessons from experiences with P4P to date, and ways to improve the designs of P4P programs are becoming apparent. We anticipate that a “second generation” of P4P programs can now be developed that can have greater impact and be better integrated with other interventions to improve the quality of care and reduce costs.

This report examines recent activation policies in the United Kingdom aimed at moving people back into work. It offers insight into how countries can improve the effectiveness of their employment services and also control spending on benefits.

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

The third installment in the Pathways to Quality Health Care series, Rewarding Provider Performance: Aligning Incentives in Medicare, continues to address the timely topic of the quality of health care in America. Each volume in the series effectively evaluates specific policy approaches within the context of improving the current operational framework of the health care system. The theme of this particular book is the staged introduction of pay for performance into Medicare. Pay for performance is a strategy that financially rewards health care providers for delivering high-quality care. Building on the findings and recommendations described in the two companion editions, Performance Measurement and Medicare's Quality Improvement Organization Program, this book offers options for implementing payment incentives to provide better value for America's health care investments. This book features conclusions and recommendations that will be useful to all stakeholders concerned with improving the quality and performance of the nation's health care system in both the public and private sectors.

In the light of better and more detailed administrative databases, this open access book provides statistical tools for evaluating the effects of public policies advocated by governments and public institutions. Experts from academia, national statistics offices and various research centers present modern econometric methods for an efficient data-driven policy evaluation and monitoring, assess the causal effects of policy measures and report on best practices of successful data management and usage. Topics include data confidentiality, data linkage, and national practices in policy areas such as public health, education and employment. It offers scholars as well as practitioners from public administrations, consultancy firms and nongovernmental organizations insights into counterfactual impact evaluation methods and the potential of data-based policy and program evaluation.

This book contains a collection of works showcasing the latest research into global health economics conducted by leading experts in the field from the Centre for Health Economics (CHE) at the University of York and other partner research institutions. Each chapter focuses upon an important topic in global health economics and a number of separate research projects. The discussion delves into health care policy evaluation; economic evaluation; econometric and other analytic methods; health equity and universal health coverage; consideration of cost-effectiveness thresholds and opportunity costs in the health sector; health system challenges and possible solutions; and others. Case study examples from a variety of low- and middle-income countries (LMIC) settings are also showcased in the final part of this volume.The research presented seeks to contribute toward increasing understanding on how health policy can be enhanced to improve the welfare of LMIC populations. It is strongly recommended for public health policymakers and analysts in low- and middle-income country settings and those affiliated to international health organizations and donor organizations.