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Related Experiment Videos

Pay for performance: rationale and potential implications for urology.

Chris M Gonzalez1, David Penson, Beth Kosiak

  • 1Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. CGonzalez@nmff.org

The Journal of Urology
|June 15, 2007
PubMed
Summary
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Pay for performance (PFP) reimbursement models are emerging in healthcare. While PFP programs are being implemented, specific evidence-based quality metrics for urology are currently lacking.

Area of Science:

  • Healthcare Reimbursement
  • Health Services Research
  • Urology

Background:

  • Pay for performance (PFP) represents a shift towards value-based purchasing in healthcare.
  • Government and private payers are increasingly interested in PFP systems.
  • Several PFP programs are already operational.

Purpose of the Study:

  • To discuss the rationale behind pay for performance initiatives.
  • To explore the implications of PFP for practicing urologists.
  • To review the current landscape of PFP in healthcare.

Main Methods:

  • A review of MEDLINE and internet-based research was conducted.
  • Research focused on healthcare quality measures, PFP implementation, and payer experiences.
  • Analysis included structure, process, and outcome measures.

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Main Results:

  • Healthcare quality is assessed using structure, process, and outcome measures.
  • These measures are most effective when risk-adjusted and used in coordination.
  • Limited data currently exist to confirm if PFP reimbursement improves healthcare quality.

Conclusions:

  • Significant questions remain regarding PFP implementation in urology.
  • Urology lacks specific, evidence-based metrics to define quality fairly and accurately.
  • Proactive urology involvement in developing quality metrics is crucial as PFP appears inevitable.