Reimbursement and Pay-for-Performance
Over the years there has been a pervasive issue in health care because of the Pay-for-Performance (P4P) Programs. Pay-for-performance is defined as a plan of reimbursement that connects compensation to quality and effectiveness as a motivation to develop the health care quality as well as making a decrease in costs. Hospitals and providers are being encouraged by government agencies and individual health plans to encourage excellence standards. Pay-for-performance methods could cause consequences such as reduction admission to care, add differences care, and weaknesses to improve. There could be an impact of the health care quality and efficiency by providers getting financial rewards if they show better care for patients as well as
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Providers that give the economical care yet meeting the greatest specific standards, will get the biggest reimbursement (Santo, 2013). An impact also is that many providers are being near ability in their capacity to offer better care. When there is a list of subjective measures that needs to be followed for providers to be reimbursed, this only confuses and aggravates the providers. Also when providers see their reimbursement is being cut, this makes them to stop serving the severely ill patients. By stop seeing some patients, this gives them time to up the quality of care and “lower the cost at the same time” (Santo, 2013). With CMS deeming the way reimbursement is being done, many providers will refuse to take on new Medicare patients. This will have a big impact on many older adults who may have to change providers for some reason or another. As pay-for-performance is becoming more involved in health care, providers will see a drop in reimbursements. One way for hospitals to show remarkable cost savings is to format guidelines for common use without losing quality of care (VHA, 2013).
P4P Affects Health Care Providers and Customers Even though P4P is to give providers incentives to give quality care and lower costs, it is still in the early stages and cannot decide whether P4P is going to be effective in lowering