Reimbursement and Pay for Performance

America has experienced dramatic changes since the incorporation of rules and regulations of standards, certain ones have been beneficial some have not. Whatever the changes are, they need to be based on what Americans needs as a whole. Physicians can help to reform the health care system by giving more Americans access to quality, reasonable health insurance and help restrict the growth of healthcare spending in the United States. With changes such as the pay-for-performance, which was formulated to undertake as a whole, was to improve the all-inclusive realm of health care, basically be more efficient. The intent is to provide incentives to providers who follow programs be financially compensated for the improved outcomes of their patients. Patients would increase pressure to providers to be motivated to perform and be accountable for their actions.

Previous payment methods provided physicians with a small incentive in improving the quality of care to their patient. According to the Institute of Medicine (IOM), they have requested restructure of payment systems to strengthen standing payment methods by providing incentives to physicians for quality improvement (AAFP, 2004). The pay-for –performance is a reimbursement model where “physicians and hospitals are paid more than others for the same services” because they have been able to deliver better quality care, proof from patients who have better outcomes (Mayes, 2006). Typically the incentives come in the form of bonuses for meeting or exceeding certain targets and quality benchmarks. In situations where the physician(s) is not meeting the target or benchmark standards, they will get a penalty.

There are payment systems in place that rewards doctors and hospitals to improve the quality of care. While some physicians are personally motivated to provide the best care they, however, lack content and structure as in the lacking structure of payment motivations to give the action needed to improve quality and...