A detailed description and origins of pay for performance
Pay-for-performance initiatives are designed to improve the efficiency, quality and general value of health care. Other terms used to refer to pay-for-performance include pay-for-quality, alternative payment, valued-based payment, among others. No matter the nomenclature, the main objective of pay-for-performance is to improve efficiency for optimal outcomes. (Rosenthal et al., 2005)
During the early 1990s, many consumers opted for managed care by paying some cash to the providers for a particular set of services. Such arrangement led to compromised quality and put some strain on patients.
Come 2000, the US was experiencing serious deficiency in health care quality. The Institute of Medicine wrote a detailed report on this. Thus pay-for-performance became a valid option for quality health care. (Vogenberg & Smart, 2018)
Who is affected by pay-for-performance?
A number of studies have been conducted to evaluate adherence to medication versus medication subsidies, but no valid conclusions have yet been made. Medication adherence was shown to improve with higher drug coverage, reduction of cost-sharing and prescription cap. Poor adherence to medication was observed for patients with full medication subsidies. Such non-detailed conclusions show the need for further studies on factors influencing patientsâ€™ adherence to medication. (Rosenthal et.al 2005)
According to Barello et.al (2012), chronic illness patients who are required to pay for their medication are more likely to tone down their use of medication. A study conducted in the US revealed that about 25% of older patients ignore their prescribed medicines due to the high costs.
Public insurers such as Medicare have frequently used pay-for-performance in hospitals. Private health care providers have also used more than forty pay-for-performance programs. However, it is still doubtful whether they improve quality. The few studies which attempt to prove improvement in health care quality under pay-for-performance have not adequately linked the two. (Barello et.al 2012)
Premier Inc. and CMS are two notable nationwide hospital systems which are undertaking a project to demonstrate the pay-for-performance. The participants get more cash for treating Medicare patients with conditions such as heart failure, coronary artery bypass graft, acute myocardial infarction, pneumonia, and hip and knee replacements. On 31st March, 2018, 414 Premier hospitals were allowed to enroll for the project and 267 of these agreed to participate. (Vogenberg & Smart, 2018)
Rosenthal et.al (2005) states the importance of the lessons from the pay-for-performance project.
Legislation and/or policies related to pay-for-performance
The Affordable Care Act outlines a number of strategies to improve health care quality. Not all these are strictly pay-for-performance. An example is the Hospital Re-admissions Reduction Program by Medicare which kicked off on 1st October, 2012. This reduces hospital payments by 1% in case of extremely high rates of avoidable re-admissions for illnesses such as heart failure, heart attack or pneumonia. (Eijkenaar et.al 2013)
The Accountable Care Organizations (ACOs) are one of the best known groups of providers who accept the role of coordinating health care and hold themselves accountable for the quality of services they render. (Barello et.al 2012)
The Office of Personnel Management was created under the Civil Service Reform Act in 1978. Some of the functions of this office included: Overseeing the human resource management of the Merit Systems Protection Board and prevent abuse of office. (Eijkenaar et.al 2013) The act also had provision for performance appraisal for the employees, merit pay for different levels of employment, and ways to deal with poor performance. In addition, the act specified that employees would get only half of their normal normal salary increase. The other half would be shared among the top performers. Thus some employees benefited with this new system whereas others were disadvantaged by receiving less pay. (Rosenthal et.al 2005)
One good thing with the Act is the fact that it made clear job expectations and set the goals and objectives. The downfall of it was its failure to establish a clear relationship between performance and pay. Managers in the new system would earn less than non-managerial employees in the old system. And that is the reason why many complained how unfair it was. The public also showed their dissatisfaction with government executives receiving large paychecks. The Act was therefore not an reliable tool for civic reforms. (Eijkenaar et.al 2013)
The year 1982 saw a significant reduction in the size and cost of many sectors of government, thanks to the president elect Ronald Reagan. This greatly limited the Service Reform Act. The Performance Management and Recognition System was put in place on 8th November, 2018 to address the shortcomings of the Civil Service Reform Act. The PMRS was able to set upper and lower limits of pay. Also, the PMRS formed Performance Standard Review Boards. Half of the members to this board were under the merit payment system, and this worked well because they had interest in solving potential problems.
PMRS was certainly better than the Civil Service Reform Act, but it only lasted for 8 years, that is from 1984 to 1991. Its ousting was attributed to insufficient performance findings, performance level discrimination, and failure to prove the system improved performance. More than half of the employees felt their reward was not enough, while more than three-quarters of the managers said that their evaluation of performance provided no guidance for them to develop. (Eijkenaar et.al 213)
Regulatory agencies that implement policies related to pay-for-performance
President Donald J. Trump, on 20th January, 2017 ordered the repeal of the Patient Protection and Affordable Care Act of 2010 (PPACA). He urged the Secretary of Health and Human Services (HHS) and other departmental leaders to avoid imposing an economic burden on the people of the USA. (Vogenberg & Smart, 2018) Such legislation has been difficult to repeal. President Trump appended his signature to one more executive order on 12th October, 2017 to completely dismantle the ACT. (Eijkenaar et.al 2013)
President Trumpâ€™s government has also transformed the health care sector through the Food and Drug Administration (FDA). The new FDA commissioner has put into effect some policies to to address issues such as increasing drug review efficiency, high prices for drugs, pursue digital health technology, innovate medical devices, and clearing the orphan drug request backlog.
What does the future hold for pay-for-performance?
Federal Government agencies have lately devised better systems of pay-for-performance by emphasizing on performance and not tenure. It is evident that any agency wishing to implement a successful pay-for-performance system must invest money, time and effort in the conception and implementation stage. (Barello et.al 2012) A fair system is that which includes a thorough performance evaluation and effective supervisors who can do the implementation. Training of the implementing employees is important if the system is to accomplish its objectives. The two main objectives for such systems is to provide a pay reflecting the value of work done, and incentives to those who perform excellently. Agencies must tailor their pay-for-performance systems to suit their own objectives and staff. And that is the main item under discussion in this report, how agency leaders should make decisions on the design and implementation of such pay-for-performance systems. The report further helps agency leaders to understand how they can tailor pay-for-performance systems to suit different organizations. The leaders are also given insight on how to measure and reward performance. (McPhie & Sapin, 2006)
Barello, S., Graffigna, G., & Vegni, E. (2012). Patient engagement as an emerging challenge for healthcare services: mapping the literature. Nursing research and practice, 2012.
Eijkenaar, F., Emmert, M., Scheppach, M., & SchÃ¶ffski, O. (2013). Effects of pay for performance in health care: a systematic review of systematic reviews. Health policy, 110(2-3), 115-130.
McPhie, A., & Sapin, B. J. (2006). Designing an Effective Pay for Performance Compensation System. US Merit Systems Protection Boar, 1, 56.
Rosenthal, M. B., Frank, R. G., Li, Z., & Epstein, A. M. (2005). Early experience with pay-for-performance: from concept to practice. Jama, 294(14), 1788-1793.
Vogenberg, F. R., & Smart, M. (2018). Regulatory Change Versus Legislation Impacting Health Care Decisions and Delivery. Pharmacy and Therapeutics, 43(1), 34.
Get Professional Assignment Help Cheaply
Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?
Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.
Why Choose Our Academic Writing Service?
- Plagiarism free papers
- Timely delivery
- Any deadline
- Skilled, Experienced Native English Writers
- Subject-relevant academic writer
- Adherence to paper instructions
- Ability to tackle bulk assignments
- Reasonable prices
- 24/7 Customer Support
- Get superb grades consistently
Online Academic Help With Different Subjects
Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
What discipline/subjects do you deal in?
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Are your writers competent enough to handle my paper?
Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
What if I don’t like the paper?
There is a very low likelihood that you won’t like the paper.
- When assigning your order, we match the paper’s discipline with the writer’s field/specialization. Since all our writers are graduates, we match the paper’s subject with the field the writer studied. For instance, if it’s a nursing paper, only a nursing graduate and writer will handle it. Furthermore, all our writers have academic writing experience and top-notch research skills.
- We have a quality assurance that reviews the paper before it gets to you. As such, we ensure that you get a paper that meets the required standard and will most definitely make the grade.
In the event that you don’t like your paper:
- The writer will revise the paper up to your pleasing. You have unlimited revisions. You simply need to highlight what specifically you don’t like about the paper, and the writer will make the amendments. The paper will be revised until you are satisfied. Revisions are free of charge
- We will have a different writer write the paper from scratch.
- Last resort, if the above does not work, we will refund your money.
Will the professor find out I didn’t write the paper myself?
Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.
What if the paper is plagiarized?
We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.
When will I get my paper?
You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.
Will anyone find out that I used your services?
We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.
How our Assignment Help Service Works
1. Place an order
You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.
2. Pay for the order
Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.
3. Track the progress
You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.
4. Download the paper
The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.
PLACE THIS ORDER OR A SIMILAR ORDER WITH US TODAY AND GET A PERFECT SCORE!!!