Evaluate the statement that P4P is the latest fad in healthcare reimbursement

Evaluate the statement that P4P is the latest fad in healthcare reimbursement

Evaluate the statement that P4P is the latest fad in healthcare reimbursement

C H A P T E R 1 2

STRATEGIC PLANNING AND PAY FOR PERFORMANCE

KEY TERMS AND CONCEPTS

➤ Intensivists

➤ Leapfrog Group

➤ Pay-for-performance (P4P) programs

Knowing is not enough; we must apply. Wil l ing is not enough; we must do.

—Johann Wolfgang von Goethe

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1 6 0 E s s e n t i a l s o f S t r a t e g i c P l a n n i n g i n H e a l t h c a r e

INTRODUCTION According to The Commonwealth Fund (see Highlight 12.1), waste and medical errors add $100 billion to U.S. healthcare expenses and may cost 150,000 lives annually. To encourage quality improvement and more efficient delivery of healthcare services, the government, insur- ance companies, and other groups implement pay-for-performance (P4P) programs, which offer financial incentives to physicians, hospitals, and other healthcare providers in exchange for meeting certain performance targets. P4P initiatives can also reduce the payments providers receive if they commit medical errors, have poor quality outcomes, or incur excessive costs.

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