E: Pay for Performance[1].Doc

RUNNING HEAD: POSITION PAPER

Position Paper: Quality Care Initiatives

Lindsey Herlinger, BSN, RN, Stephanie Higbee, BSN, RN, & Kayla Morris, BSN, RN

Policy and Politics NUR525

Chad Rittle BSN, MPH, DNP, RN

December 16, 2010

Introduction

Quality care is one of the main focal points in today’s healthcare settings. Accelerating quality care and performance by medical professionals achieves better patient outcomes, enhances safety, improves patient satisfaction and often determines if an institution will become accredited. Even though quality care has been determined as an essential component, there has been much debate on what defines “quality care” and how it should be measured. Clinical performance measures are being used by more hospitals as one way to gauge this. Providing quality care is also becoming an incentive for many healthcare workers due to the arising pay for performance era. Pay for performance, also known as P4P, is an emerging movement in healthcare systems that reward healthcare providers for meeting certain performance goals related to quality care. The momentum behind P4P is a reaction to the rising cost of medical care, growth of chronic conditions, and demands by purchasers for the improvement of quality care. P4P is based on the theory that rewards and bonuses motivate employees to do a better job. However, this has not yet been proven to be true. Many proponents of this issue feel that pay for performance is an excellent concept, but critics believe it can cause serious harm. Several pilot studies are underway at a great number of medical facilities and Medicare has begun implementing P4P strategies.

Ethics and P4P

It is unrealistic to think that all incentive programs work. It is even more unrealistic to believe this when instilling it in a medical setting. The Deficit Reduction Act of 2005 mandated the Center for Medicaid and Medicare Services adopt a pay for performance model into Medicare. P4P programs are...