TY - JOUR
T1 - An official American Thoracic Society policy statement
T2 - Pay-for-performance in pulmonary, critical care, and sleep medicine
AU - Kahn, Jeremy M.
AU - Scales, Damon C.
AU - Au, David H.
AU - Carson, Shannon S.
AU - Curtis, J. Randall
AU - Dudley, R. Adams
AU - Iwashyna, Theodore J.
AU - Krishnan, Jerry A.
AU - Maurer, Janet R.
AU - Mularski, Richard
AU - Popovich, John
AU - Rubenfeld, Gordon D.
AU - Sinuff, Tasnim
AU - Heffner, John E.
PY - 2010/4/1
Y1 - 2010/4/1
N2 - Rationale: Pay-for-performance is a model for health care financing that seeks to link reimbursement to quality. The American Thoracic Society and its members have a significant stake in the development of pay-for-performance programs. Objectives: To develop an official ATS policy statement addressing the role of pay-for-performance in pulmonary, critical care and sleep medicine. Methods: The statement was developed by the ATS Health Policy Committee using an iterative consensus process including an expert workshop and review by ATS committees and assemblies. Measurements and Main Results: Pay-for-performance is increasingly utilized by health care purchasers including the United States government. Published studies generally show that programs result in small but measurable gains in quality, although the data are heterogeneous. Pay-for-performance may result in several negative consequences, including the potential to increase costs, worsen health outcomes, and widen health disparities, among others. Future research should be directed at developing reliable and valid performance measures, increasing the efficacy of pay-for-performance programs, minimizing negative unintended consequences, and examining issues of costs and cost-effectiveness. The ATS and its members can play a key role in the design and evaluation of these programs by advancing the science of performance measurement, regularly developing quality metrics alongside clinical practice guidelines, and working with payors to make performance improvement a routine part of clinical practice. Conclusions: Pay-for-performance programs will expand in the coming years. Pulmonary, critical care and sleep practitioners can use these programs as an opportunity to partner with purchasers to improve health care quality.
AB - Rationale: Pay-for-performance is a model for health care financing that seeks to link reimbursement to quality. The American Thoracic Society and its members have a significant stake in the development of pay-for-performance programs. Objectives: To develop an official ATS policy statement addressing the role of pay-for-performance in pulmonary, critical care and sleep medicine. Methods: The statement was developed by the ATS Health Policy Committee using an iterative consensus process including an expert workshop and review by ATS committees and assemblies. Measurements and Main Results: Pay-for-performance is increasingly utilized by health care purchasers including the United States government. Published studies generally show that programs result in small but measurable gains in quality, although the data are heterogeneous. Pay-for-performance may result in several negative consequences, including the potential to increase costs, worsen health outcomes, and widen health disparities, among others. Future research should be directed at developing reliable and valid performance measures, increasing the efficacy of pay-for-performance programs, minimizing negative unintended consequences, and examining issues of costs and cost-effectiveness. The ATS and its members can play a key role in the design and evaluation of these programs by advancing the science of performance measurement, regularly developing quality metrics alongside clinical practice guidelines, and working with payors to make performance improvement a routine part of clinical practice. Conclusions: Pay-for-performance programs will expand in the coming years. Pulmonary, critical care and sleep practitioners can use these programs as an opportunity to partner with purchasers to improve health care quality.
KW - Health care disparities
KW - Health insurance reimbursement
KW - Incentives
KW - Medicare
KW - Quality assurance
KW - Quality indicators
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U2 - 10.1164/rccm.200903-0450ST
DO - 10.1164/rccm.200903-0450ST
M3 - Article
C2 - 20335385
AN - SCOPUS:77951935526
SN - 1073-449X
VL - 181
SP - 752
EP - 761
JO - American journal of respiratory and critical care medicine
JF - American journal of respiratory and critical care medicine
IS - 7
ER -