DQ Do you think it is important for health care organizations to be paid for quality of performance?
REPLY TO DISCUSSION
According to Sura and Shaw, quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes. This is based on evidence based professional knowledge and is necessary for achieving universal health coverage. Sura and Shaw further explain that Payers assess quality based on patient outcomes as well as a provider’s ability to contain costs. Providers earn more healthcare reimbursement when they are able to provide high-quality, low-cost care as compared with that of their peers The pay-for-performance (P4P) initiatives have been suggested as a way to improve the quality of patient care and provide incentives to improve performance from providers.
In 2003, The Centers for Medicare & Medicaid Services endorsed this P4P initiative to strengthen quality measures, improve patient outcomes and maintain physician accountability. It offered incentives to hospitals, provider groups, and physicians based on adherence to specific metrics. What the data showed was that quality composite scores promoted by CMS with the P4P programs needed improvement. They focused on initiatives to target high and low performers and ways to influence care. The goals of the project were straightforward and that was to reward or financially incentivize healthcare stakeholders to provide high quality care.
I think rewarding rates of improvement is important as it can potentially drive healthcare systems to produce higher results. It encourages organizations to invest in quality improvement. By creating financial incentives for providers to participate in P4P, it allows providers to focus on patients’ specific needs. According to Penner, there were also fewer hospital readmissions within two years following the implementation of a readmission reduction program, particularly among Medicare patients (Penner, 2016). I think that our healthcare industry is ever evolving but changes are continuously strengthening our system.
Penner, S. (2016). Economics and financial management for nurses and nurse leaders (3rd ed.). Springer Publishing Company
Sura, A., & Shah, N. R. (2010). Pay-for-Performance Initiatives: Modest Benefits for Improving Healthcare Quality. American health & drug benefits, 3(2), 135–142.
Discuss the link between payment and quality. Is paying for quality a good thing? Provide rationale.
Yes it is important. Quality improvement is necessary for any organization to remain relevant and gain confidence with the general
public. People work hard for their money. No one likes spending there hard earned cash on something that is of poor quality. Healthcare institutions should be at the frontline of providing quality healthcare service to the public, because the not only provide health care to all of us, but most importantly they also contribute to the improvement of our healthcare and quality of life for all of us.
Nancy Dean Beaulieu, & Arnold M. Epstein. (2002). National Committee on Quality Assurance Health-Plan Accreditation: Predictors, Correlates of Performance, and Market Impact. Medical Care, 40(4), 325–337.
Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: DQ: Do you think it is important for health care organizations to be paid for quality of performance?
It is important for healthcare organizations to focus in improving and providing quality of care to their patients. Quality of performance would involve improving healthcare delivery to patients in their community. Healthcare organizations would need to focus on identifying where their facility is lacking. Performance improvement helps healthcare organizations identify what type of quality of care is being provided to patients and allows the healthcare organization make improvements based on the feedback that is being provided. Healthcare organizations should be paid based on their performance providing quality of care. I think it is important and necessary to evaluate what type of care healthcare is being provided to patients. Providing top notch quality of care to the community would also bring other benefits to healthcare organizations by stressing quality of care over quantity of care. This incentive of getting paid for quality of care would allow healthcare organizations to focus more on their practices, processes, and policies to provide and promote positive health outcomes. Patients deserve to receive excellent patient care while keeping the cost of care down. That is why it is so important for nursing professionals track patient satisfaction and reducing cost by measuring patient outcomes. Measuring performance outcomes will allow the organization to achieve and improve patient quality of care.
Agency of Healthcare Research and Quality. (2020). Quality Improvement in Primary Care. https://www.ahrq.gov/research/findings/factsheets/quality/qipc/index.html
The current drive is to provide consumers with education in order to make informed choices. You see this with the Medicare Compare websites, the emphasis on transparency, and the mandated quality reporting measures.
According to the American Medical Informatics Association (n.d.), health consumer informatics is a field that focuses on informatics from multiple perspectives or patient views. The emphasis is on consumer education and health literacy through information structures and processes to manage their own health.
We are seeing this emphasis in our own organizations. Web sites have become much easier to navigate. We are seeing increased access to patient education materials on our site that are easy to understand. Patient preferences for education are being assessed upon admission to organizations.
“The shift in this view of informatics analyzes consumers’ needs for information; studies and implements methods for making information accessible to consumers; and models and integrates consumers’ preferences into health information systems” (American Medical Informatics Association, n.d., para 1).
Class – how do you see your patients and consumers using quality to make decisions?
American Medical Informatics Association. (n.d.). Consumer health informatics. https://www.amia.org/applications-informatics/consumer-health-informatics
According to the World Health Organization (2022), quality health care should be successfully managing care for patients when needed, safe practicing techniques to prevent harm, and person-centered based on their desires. Patients often select a place to obtain care based on past experiences from themselves or loved ones. Patients might even consider researching various establishments and their quality scores based on their particular needs. Even though we have defined quality indicators some may elect to choose based on their personal experiences rather than specific data- which according to WHO is a quality indicator. My experiences with patients using quality to make decisions is based upon their own perceptions of quality.
World Health Organization. (2022). Quality of care. https://www.who.int/health-topics/quality-of-care#tab=tab_1
In the current state of hospitals and physicians increased transparency with their quality metrics this gives the patient the ability for patients to shop around. Patients want and desire higher quality of care and will look for the hospital or physician with higher quality scores. Higher quality of care equated to decreased adverse events, patients do not want to have adverse events in their medical care and will seek a physician to offer the highest quality of care. Value based purchasing or customer focused service attributes to the product the consumer is looking for and if a patient has the ability to equally choose a costly treatment, they will prefer to get eth best value for their money at the higher quality, marked focused focusing situation give the customer the ability to shop around for the best price as well as the best quality (Penner, 2016). We have created a quest for quality in our culture and patient a desire to be free from adverse events and have great quality of care (Rundio & Al, 2021)
Penner, S. J. (2016). Economics and financial management for nurses and nurse leaders, third edition (3rd ed.) [e-book]. Springer Publishing LLC.
Rundio, & Al. (2021). The nurse manager’s guide to budgeting and finance, 3rd edition (3rd ed.) [original]. SIGMA Theta Tau International.
Patients are using surveys to make their voices heard. Hospitals mail out or email surveys to patients after they have received care. The purpose of the hospital survey is to help the healthcare organization bring forth the patients view on the care that was received. The healthcare organization then uses the survey information to compare it to other healthcare organizations in the community. The survey results are also beneficial to the healthcare organization because it provides new ways to create new performance improvement projects where the survey showed deficiencies. The hospital can focus on these new quality improvement measures to enhance the quality of care that is being provided to the consumers in the community. The overall goal of implementing performance improvement projects based on survey responses is to improve patient outcomes, improve staff efficiency, reduce waste but overall, it is about improving patient care.