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Methods Of Healthcare Delivery System01:26

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At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
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An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...
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Pay for performance in commercial HMOs.

Meredith B Rosenthal1, Bruce E Landon, Sharon-Lise T Normand

  • 1Department of Health Policy and Management, Harvard School of Public Health, Boston, USA.

The New England Journal of Medicine
|November 3, 2006
PubMed
Summary
This summary is machine-generated.

Pay for performance programs are common in health maintenance organizations (HMOs), with over half using them in provider contracts. This approach is linked to plan characteristics and market factors, offering insights for Medicare.

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Area of Science:

  • Health Services Research
  • Healthcare Management
  • Health Economics

Background:

  • Pay for performance (P4P) is a growing area of interest in healthcare, particularly with potential adoption by Medicare.
  • The national prevalence and characteristics of P4P programs in health plans remain largely unknown.

Purpose of the Study:

  • To determine the prevalence of P4P programs within health maintenance organizations (HMOs).
  • To detail the features of existing P4P programs.
  • To examine factors influencing the adoption of P4P by health plans and markets.

Main Methods:

  • A national survey of 252 HMOs was conducted, achieving a 96% response rate.
  • Data collected included the use, features, and adoption drivers of P4P programs.
  • Statistical analysis examined the association between P4P adoption and health plan/market characteristics.

Main Results:

  • Over 50% of surveyed HMOs utilize P4P in provider contracts, covering more than 80% of enrolled individuals.
  • Among plans with P4P, nearly 90% included physicians, and 38% included hospitals.
  • P4P adoption correlated with geographic region, gatekeeping by primary care providers (PCPs), PCP capitation payment, and plan performance-based incentives.

Conclusions:

  • P4P is widely adopted by HMOs, particularly those structuring care around PCPs or medical groups.
  • Leveraging the commercial market's P4P experience is crucial as Medicare develops its P4P initiatives.