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Buy-Right for Health Care Quality: Evidence and Indicators: Paying for Performance
Slide Presentation by Carolyn Clancy, M.D.
On October 21, 2004, Dr. Clancy made a presentation in a Web conference entitled Buy-Right for Health Care Quality: Evidence and Indicators: Paying for Performance.
This is the text version of Dr. Clancy's slide presentation. Select to access the PowerPoint® Slides (72 KB).
Paying for Performance: Introductory Comments
Carolyn Clancy, M.D.
Agency for Healthcare Research and Quality
October 21, 2004
2001 IOM Report: Crossing the Quality Chasm
- There are serious problems in quality
- Between the health care we have and the care we could have lays not just a gap but a chasm.
- The problems come from poor systems... Not bad people.
- Chasm stems from two overarching problems:
- How we pay for care.
- How we organize and structure care.
- Also need improved information technology.
AHRQ Role in Measurement and Data for Incentives Work
- National tracking and benchmarks:
- National Healthcare Quality and Disparities Reports.
- Measuring local experience of care:
- CAHPS® for plans, hospitals, nursing homes etc.
- Measuring hospital quality and safety:
- Inpatient Quality Indicators, Patient Safety Indicators.
- Measuring potentially avoidable admissions:
- Prevention Quality Indicators.
Growing Private Sector Interest
- Rosenthal, et al, (Health Affairs 2004) identified 37 separate incentive plans representing 31 different payers.
- Rewarding Results Demonstrations:
- Blue Cross Blue Shield of Michigan.
- Blue Cross of California.
- Bridges to Excellence.
- California Health Care Strategies/Medi-Cal.
- Excellus/Rochester IPA.
- Integrated Healthcare Association.
- Massachusetts Health Plan Quality Partners.
- Financial incentives are inherent in any and all payment systems.
- It is not a question of incentives vs. no incentives.
- Unintended incentives can be as strong as intended ones.
- Financial incentives are just one force shaping quality.
Current as of March 2005
Paying for Performance: Introductory Comments. Text version of a slide presentation at a Web conference. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/buyright/clancytxt.htm
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