Article

Pay-for-Performance in Nursing Homes

University of Massachusetts Medical School and Meyers Primary Care Institute, Worcester, Massachusetts 01605, USA.
Health care financing review (Impact Factor: 2.06). 02/2009; 30(3):1-13.
Source: PubMed

ABSTRACT Information on the impact of pay-for-performance programs is lacking in the nursing home setting. This literature review (1980-2007) identified 13 prior examples of pay-for-performance programs in the nursing home setting: 7 programs were active as of 2007, while 6 had been terminated. The programs were mostly short-lived, varied considerably in the choice of performance measures and pay incentives, and evaluations of the impact were rare.

0 Followers
 · 
143 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The objective of the study was to assess the association between care quality of skilled nursing facilities (SNFs) and 30-day risk-adjusted readmission rate (RAR) for patients with acute decompensated heart failure (ADHF). A retrospective cohort study was conducted involving 603 discharges from a tertiary care hospital to 17 SNFs after hospitalization for ADHF. SNF quality was assessed based on the CMS 5-star quality rating and a survey of SNF characteristics and processes of care. In all, 20% of cases were readmitted within 30-days; 9.4% were for ADHF. The all-cause RARs for higher- and lower-quality SNFs were 18% (95% confidence interval [CI] = 14%-23%) and 22% (95% CI = 17%-26%), respectively, and the ADHF RARs were 8.8% (95% CI = 6.0%-11.6%) and 10.2% (95% CI = 7.0%-12.9%), respectively. There were no significant associations between ADHF RARs and individual processes of care or structural characteristics. Quality ratings of SNF or processes of care did not correlate with RAR.
    American Journal of Medical Quality 04/2014; DOI:10.1177/1062860614531069 · 1.78 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The research presented here provides some descriptive information of nursing home pay for performance (P4P) initiatives and an examination of the opinions of Nursing Home Administrators (NHAs) about P4P. Opinions on three common elements of P4P were examined: the incentive format, program format, and quality format. Information came from a mail survey of 2,426 NHAs. Most of the summary scores show that few NHAs gave positive responses to P4P. Very few NHAs believed that P4P would increase their revenues. NHAs were skeptical that P4P systems were for quality improvement and instead believed they were developed for purposes of cost-reduction. Relatively few NHAs believed that P4P would improve quality of care. Given that we have limited experience with setting performance goals and incentive formats for NHAs, the findings presented may prove useful in modeling future P4P systems.
    Journal of Aging & Social Policy 04/2014; DOI:10.1080/08959420.2014.899185 · 0.60 Impact Factor
  • Public Administration Review 09/2013; 73(s1). DOI:10.1111/puar.12124 · 0.84 Impact Factor

Preview

Download
3 Downloads
Available from