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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

Slide 1

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.

Slide 2

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.

Slide 3

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.

Slide 4

Framing Observations

  • 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

Internet Citation:

Paying for Performance: Introductory Comments. Text version of a slide presentation at a Web conference. Agency for Healthcare Research and Quality, Rockville, MD.

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