Improving Qualtiy & Decreasing Costs in the Delivery of Healthcare

Session
Financial/Human Resource Performance

Author
Polly Royal
MS, RN-BC
Purdue University

Description
The U.S. spends $2 trillion annually on healthcare, yet ranks only 37th in quality of healthcare delivered. Poor-quality healthcare results in an increased number of complications and healthcare costs. Pay for performance should replace the current form of reimbursement used in the U.S. and has great potential for driving quality improvement.

Abstract
The United States spends $2 trillion per year on healthcare, yet ranks only 37th in overall quality of healthcare delivered. The pursuit of evidence-based practice is now at the core of the agenda for improving healthcare in the U.S. Poor-quality healthcare results in an increased number of complications and increased healthcare costs for all payers. Other than altruism, there are few incentives to change the status quo. The Institute of Medicine's To Err is Human: Building a Safer Health System illuminates the need for improved safety and quality in the U.S. healthcare system. Pay for performance (P4P) describes four types of quality measures: patient outcomes, processes, structural factors, and patient satisfaction.

This presentation examines the history of regulations, managed care, and the advent of pay for performance. The tie between P4P and information technology is explored. The pros and cons of P4P are discussed. P4P is a potential solution to improving the quality and decreasing the costs of healthcare in America. The policy window regarding the implementation of P4P is investigated.

This presentation concludes that pay for performance should replace the current form of reimbursement used in the U.S. and P4P has great potential for driving quality improvement.