response discussion

Week 3 Main Post

Clinical performance measures are supported by much data to show an overall improvement of services, are typically initiated by health networks to motivate their providers to improve the overall care and patient satisfaction, as well as to satisfy insurance companies. There are concerns by many however that these measures are not necessarily improving care; but instead promoting overuse (Newton, Zazzera, Van Moorsel & Sirovich, 2015). Many providers can argue that they perform some measures more so that they do not get reprimanded for not doing so, and not because it was clinically appropriate, or something that they were going to add to their plan of care anyway. Any health care system will promote the ideas of improvements in their products and their accountability, and offering it all up at an acceptable price to the consumer, but developing reasonable measures should be at the forefront (Berenson, Pronovost & Krumholz, 2013).

Relative value units (RVUs) are used by health care facilities to determine provider productivity and fees, and at times substantiate the need for more providers. Provider incentive plans are often implemented in order to motivate a provider to reach a clinical performance measure, and in the case of this week’s assigned article, that measure was increased RVUs and overall patient satisfaction (Rhodes, Bechtle & McNett, 2015). Incentive payments can be a positive motivator to reaching a certain standard of care, such as a pay-for-performance model, as providers receive extra money for things such as lower readmission rates, better controlled HbA1c, and percentages of patients that were screened for certain tests, such as a colonoscopy or mammogram (Gusmano & Thompson, 2015). Overall, the patients are ones actually receiving the most benefit, as their health is being managed more appropriately, and that alone is worth it.

Refrences

Berenson, R., Pronovost, P., Krumholz, H. (2013). Achieving the potential of health care

performance measures. Timely Analysis of Immediate Health Policy Issues, pp. 1-31

Gusmano, M., Thompson, F. (2015). An examination of Medicaid delivery system reform

incentive payment initiatives under way in six states. Health Affairs, 34 (7), pp. 1162-1169

Newton, E., Zazzera, E., Van Moorsel, G., Sirovich, B. (2015). Undermeasuring overuse - an

examination of national clinical performance measures. JAMA Internal Medicine, 175 (10), pp. 1709-1711

Rhodes, C., Bechtle, M., McNett, M. (2015). An incentive pay plan for advanced practice

registered nurses: Impact on provider and organizational outcomes. Nursing Economics, 33 (3), pp. 125-132