Incentive Programs in Healthcare Discussion

Incentive Programs in Healthcare Discussion

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IIncentive Programs in Healthcare Discussion

Question Description
I don’t know how to handle this Health & Medical question and need guidance.

Each reply must be at least 450 words a peice. Each thread and reply must contain at least 2 references and 1 instance of biblical integration. Current APA format must be used.

classmate #1-

Colossians 3:23 says, “Whatever you do, work heartily, as for the Lord and not for men.” As a part of quality assurance, the government has instilled various programs as incentives for various health care facilities and health care professionals. Like the Meaningful Use program, other programs that are offered by the government “look to incentivize healthcare providers through demonstrating the delivery of quality healthcare and a commitment to quality patient outcomes” (Harrington, 2016, p. 269). Holmstrom (2017) reported that an incentive program or system that is properly designed will consider the full collection of services that a healthcare provider or facility “can engage in, the array of instruments, many nonfinancial, that are available to influence individuals and consider the factors that motivate them in different settings” (p. 1735). Two of the incentive programs that we will look at further are the Pay-for-Performance (P4P) program and the Value-Based Purchasing (VBP) program. Both programs are based on quality care, but P4P deals with healthcare providers while VBP deals with acute care hospitals.

Up until the 1990s, healthcare providers were reimbursed based on a fee-for-service system. Entering into the 1990s, healthcare payers shifted to a managed-care approach that included primary care physicians and case managers. With the continued escalating healthcare costs with little to no improvement in the quality of healthcare services, the P4P payer system was introduced in the early 2000s. When healthcare providers meet or exceed agreed-upon quality measures or performance goals, they will be provided with a bonus from the P4P program (Harrington, 2016). Healthcare providers can also be penalized for not providing quality care, not reducing healthcare costs, and even performance that is not improving. This places pressures on the healthcare providers to ensure that any healthcare services provided to patients are “safe, effective, patient-centered, timely and efficient in its delivery, and equitable for the patient” (Harrington, 2016, p. 271). Quality measures that are imposed on healthcare providers are categorized as process measures, outcome measures, patient experience, and structure measures. P4P payments to service providers are then calculated based on services rendered, the quality of services, and efficiency measures. Harrington (2016) stated that the overarching goal for the P4P program is to accurately align both the incentive program itself and the payment to providers’ processes and goal in order to eventually “produce better outcomes for the patient that will ultimately result in lower costs for the payer, provider, and patient” (p. 273). In comparison, the VBP program bases its program on a majority of the same provisions, but the program operates and requires different measures to differentiate warrant of payment.

Incentive Programs in Healthcare Discussion – Nurses Homework | Nurses Homework

The VBP program is an initiative by the Centers for Medicare and Medicaid Services (CMS) “that rewards acute-care hospitals with incentive payments based on the quality of care that they provide to the beneficiary/patient that is on Medicare while in” the health facilities care (Harrington, 2016, p. 274). The VBP program essentially rewards healthcare providers for delivering both quality and efficient clinical care. The VBP program can be complex but basically, any incentive payment is based on how well inpatient healthcare services perform based on each measure or on how much improvement, or lack thereof, has been made in that specific area since the previous measurement or baseline period. Just as in P4P, there are a handful of quality domains that hospitals are measures on, these include—the clinical process of care, patient experience of care, outcome, and efficiency. Any healthcare facility that participates in the VBP program is not only under a microscope, so to say, but also their performance is completely transparent to the public. Information gathered on a hospital’s performance in the VBP program is posted periodically for public review. This information includes “the hospital’s performance on each measure that applies, the hospital’s performance on each condition or procedure, and the hospital’s total performance” (Harrington, 2016, p. 278). Chee, Ryan, Wasfy, and Borden (2016) reported that VBP programs “will play a significant role in healthcare delivery for years to come, and they will serve as an opportunity for providers to build the infrastructure needed for value-oriented care” (p. 2197). Both the VBP program and the P4P program have initiated measures for improving the quality of healthcare services and healthcare professionals’ performance, while aiming at reducing healthcare costs. The overall impact of both the P4P program and the VBP program on any healthcare organization that is participating is that the overall financial health of the healthcare organization is directly affected by any unfavorable outcomes.