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.
Director
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. http://www.ahrq.gov/news/ulp/buyright/clancytxt.htm

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