We construct statistical models to assess whether hospital size will impact the ability to identify "true" hospital ranks in pay-for-performance (P4P) programs. We use Bayesian hierarchical models to estimate the uncertainty associated with the ranking of hospitals by their raw composite score values for three medical conditions: acute myocardial infarction (AMI), heart failure (HF), and commun...

The care of Americans with severe chronic illnesses is disorganized, unnecessarily costly, and undisciplined by sound clinical science. The federal government should invest in a crash program to improve the scientific basis of managing chronic illness, and the Centers for Medicare and Medicaid Services (CMS) should extend its pay-for-performance (P4P) agenda to ensure that within ten years all ...

OBJECTIVE To examine the effects of an intervention comprising (1) a practice-based care coordination program, (2) augmented by pay for performance (P4P) for meeting quality targets, and (3) complemented by a third-party disease management on quality of care and resource use for older adults with diabetes. DATA SOURCES/STUDY SETTING Claims files of a managed care organization (MCO) for 20,943...

HCO: Health Care Organizations; PPACA: Patient Protection and Affordable Care Act; AHH: ACME Hospital Healthcare; P4P: Pay-for-Performance; FFS: Fee-for-Service; CMS: Centers for Medicare and Medicaid Services; AMI: Acute Myocardial Infarction; HF: Heart Failure; IOM: Institution of Medicine; IS: Information System; BI: Business Intelligence; NHIN: National Health Information Network; CDR: Clin...

Introduction The Hong Kong Hospital Authority (HA) introduced a Payfor-Performance (P4P) resourceallocation policy using a Casemix system in late 2008. Clinicians played a vital role in its implementation, especially with regard to the accuracy of clinical data. The purpose of this study was to: 1. Assess the short-term impact of Casemix-based funding as perceived by clinicians on clinical prac...

The emergence of peer-to-peer (P2P) is posing significant new challenges to achieving efficient and fair utilization of network resources. In particular, without the ability to explicitly communicate with network providers, P2P applications depend mainly on inefficient network inference and network-oblivious peering, leading to potential inefficiencies for both P2P applications and network prov...

BACKGROUND Inappropriate treatment of non-malaria fevers with artemisinin-based combination therapies (ACTs) is a growing concern, particularly in light of emerging artemisinin resistance, but it is a behavior that has proven difficult to change. Pay for performance (P4P) programs have generated interest as a mechanism to improve health service delivery and accountability in resource-constraine...

BACKGROUND A number of reforms have been implemented in Swedish health care to support integrated care for frail older people and to reduce utilization of hospital care by this group. Outcomes and process indicators have been used in pay-for-performance (P4P) schemes by both national and local governments to support developments. OBJECTIVE To analyse limitations in the use of outcome and proc...

In past decades, stark differences in practice pattern, cost, and outcomes of care across regions with similar health demographics have prompted calls for reform. As health systems answer the growing call for accountability in the form of quality indices, while responding to increased scrutiny on practice variation in the form of pay for performance (P4P), a rift is widening between the system ...