Another excellent paper from the Congressional Budget Office is issued, this one on Medicare’s demonstration projects on value-based payments to providers. Once again, the demonstrations had very mixed results, with only one demonstration generating savings for the Medicare program.
When money starts getting attached to calculations, the nitty-gritty of how the data for the calculations is collected and how the calculation is defined become very important. An article in the Annals of Internal Medicine examines methods for determining hospital mortality rates, finding differences across methods that could have important financial consequences.
The Agency for Healthcare Research and Quality examines the supposed mechanisms by which public reporting of provider performance on quality measures will improve outcomes and details the evidence which supports or fails to support that theory.
The holiday season is in full swing, as is the time for bad weather, but nothing can deter the delivery of our Potpourri of health stories, including this week the nocebo effect, use of imaging when a financial interest in the equipment is present, broker commissions and the MLR, present-on-admission indicators, selecting patients for use in performance measuring, and physicians views of health insurers.
Health care is now full of all kinds of performance measures, and the results are increasingly used for payment-related purposes, raising their potential impact significantly. A new Rand report sponsored by the National Quality Forum examines the use of performance measures and evaluates their impact.
No Potpourri next week due to the holiday, so enjoy this festive collection of health care nuggets, including pay-for-performance in large physician groups, employer views on the effect of the reform law, the effect of physician financial interest in cardiac testing, experience with high deductible plans, medical homes and quality improvement and for-profit and non-for-profit hospital treatment of the uninsured.
The cold is approaching so curl up on the sofa and enjoy the warmth of our Potpourri, this week featuring results from a pay-for-performance program, the effect of the health insurance tax on premiums and employment, the evidence for a stroke treatment, collaborative care for heart disease and physicians views on their practices and health information tools.
The world’s aflame with reporting on provider quality and cost performance. Making sure the information is complete, accurate and credible is no simple task, as a recent Agency for Healthcare Research and Quality report demonstrates.
The leaves fall but not the quality of our Potpourri, this week covering beneficiaries’ use of Medicare Star ratings, quality of care guidelines and older patients, compassionate care, asthma care guidelines and outcomes, infection control in hospitals and informal caregivers in California.
Another wonderful collection of health care research summaries, including a GAO report on likely effects of the MLR rule, physician work intensity, reducing hospital-acquired infections, discharge followup and hospital readmissions, the effect of pay-for-performance on cardiac care and use of EHRs and health history recording.
A new Cochrane Review finds very minimal evidence to suggest that efforts aimed at improving quality of care by creating financial rewards or penalties for primary care physicians are having the desired impact, suggesting caution in implementing the programs until there is further and better quality research.
A paper from the National Bureau of Economic Research examines the effect of a physician pay-for-performance program in Canada. The study found very limited effects of the incentives in spurring greater delivery of the care which was incented.
Fireworks galore for the Fourth of July Potpourri, including dynamite excerpts on the effects of parent caregiving on caregivers’ financial status; health insurance exchanges; physician compensation; provider performance data gathering and use; hospital market concentration; use of HIT in nursing homes and teen use of health websites.
Provider performance reporting is spreading rapidly and increasingly has payment consequences attached to it. New research published in JAMA gives further reason to be cautious in designing and implementing these programs.