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BPH Procedural Treatment: The Case for Value-Based Pay for Performance

The concept of “pay for performance” (P4P) applied to the practice of medicine has become a major foundation in current public and private payer reimbursement strategies for both institutional and individual physician providers. “Pay for performance” programs represent a substantial shift from tradi...

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Detalles Bibliográficos
Autores principales: Stovsky, Mark, Jaeger, Irina
Formato: Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2605946/
https://www.ncbi.nlm.nih.gov/pubmed/19125179
http://dx.doi.org/10.1155/2008/954721
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author Stovsky, Mark
Jaeger, Irina
author_facet Stovsky, Mark
Jaeger, Irina
author_sort Stovsky, Mark
collection PubMed
description The concept of “pay for performance” (P4P) applied to the practice of medicine has become a major foundation in current public and private payer reimbursement strategies for both institutional and individual physician providers. “Pay for performance” programs represent a substantial shift from traditional service-based reimbursement to a system of performance-based provider payment using financial incentives to drive improvements in the quality of care. P4P strategies currently embody rudimentary structure and process (as opposed to outcomes) metrics which set relatively low-performance thresholds. P4P strategies that align reimbursement allocation with “free market” type shifts in cognitive and procedural care using evidence-based data and positive reinforcement are more likely to produce large-scale improvements in quality and cost efficiency with respect to clinical urologic care. This paper reviews current paradigms and, using BPH procedural therapy outcomes, cost, and reimbursement data, makes the case for a fundamental change in perspective to value-based pay for performance as a reimbursement system with the potential to align the interests of patients, physicians, and payers and to improve global clinical outcomes while preserving free choice of clinically efficacious treatments.
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spelling pubmed-26059462009-01-05 BPH Procedural Treatment: The Case for Value-Based Pay for Performance Stovsky, Mark Jaeger, Irina Adv Urol Review Article The concept of “pay for performance” (P4P) applied to the practice of medicine has become a major foundation in current public and private payer reimbursement strategies for both institutional and individual physician providers. “Pay for performance” programs represent a substantial shift from traditional service-based reimbursement to a system of performance-based provider payment using financial incentives to drive improvements in the quality of care. P4P strategies currently embody rudimentary structure and process (as opposed to outcomes) metrics which set relatively low-performance thresholds. P4P strategies that align reimbursement allocation with “free market” type shifts in cognitive and procedural care using evidence-based data and positive reinforcement are more likely to produce large-scale improvements in quality and cost efficiency with respect to clinical urologic care. This paper reviews current paradigms and, using BPH procedural therapy outcomes, cost, and reimbursement data, makes the case for a fundamental change in perspective to value-based pay for performance as a reimbursement system with the potential to align the interests of patients, physicians, and payers and to improve global clinical outcomes while preserving free choice of clinically efficacious treatments. Hindawi Publishing Corporation 2008 2008-12-21 /pmc/articles/PMC2605946/ /pubmed/19125179 http://dx.doi.org/10.1155/2008/954721 Text en Copyright © 2008 M. Stovsky and I. Jaeger. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Stovsky, Mark
Jaeger, Irina
BPH Procedural Treatment: The Case for Value-Based Pay for Performance
title BPH Procedural Treatment: The Case for Value-Based Pay for Performance
title_full BPH Procedural Treatment: The Case for Value-Based Pay for Performance
title_fullStr BPH Procedural Treatment: The Case for Value-Based Pay for Performance
title_full_unstemmed BPH Procedural Treatment: The Case for Value-Based Pay for Performance
title_short BPH Procedural Treatment: The Case for Value-Based Pay for Performance
title_sort bph procedural treatment: the case for value-based pay for performance
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2605946/
https://www.ncbi.nlm.nih.gov/pubmed/19125179
http://dx.doi.org/10.1155/2008/954721
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