Medicaid P4P

As part of health reform, Medicare is looking to institute value-based purchasing or pay-for-performance programs in a number of settings.   In fact, in my work for Acumen, I have worked on a number of these initiatives (e.g., P4P for physician efficiency profiling, implementing a VBP system in home health).  Medicare, however, isn’t the only…

Value-Based Insurance Design

There have been a lot of “value-based” initatives in health care of late.  Value-based purchasing aims to reward high-quality providers with either higher reimbursement rates or periodic bonuses.  On the other hand, value-based insurance targets the patient side.  The value-based insurance scheme varies cost sharing depending on whether the drug, procedure, or treatment is considered…

Value-Based Purchasing in Nursing Homes

More than 3 million frail and disabled individuals rely on nursing home services in any given year.  About half of these individuals consider the nursing home to be their primary place of residence.  Nursing home quality, however, has often been called into question. Some experts believe pay-for-performance schemes will improve nursing home quality.  Today, I…

Evaluating VBP Programs

The call for the adoption of value based purchasing programs has gained in popularity in recent years.  These programs give physicians, hospitals, or other providers bonuses (or penalties) depending on the quality of care their patients receive. The Affordable Care Act (ACA a.k.a Health Reform) includes provisions to establish a VBP program for hospital payments…

VBP Design Choices

“Pay-for-performance (P4P) is one of the primary tools used to support healthcare delivery reform. Substantial heterogeneity exists in the development and implementation of P4P in health care and its effects.” Today, I review a paper which summarizes evidence, obtained from studies published between 1990-2009, concerning P4P effects. Measure Effectiveness Which types of measures produce the…

Value-based pricing

In February of 2007, the UK’s Office of Fair Trading (OFT) recommended reform to Britain’s current Pharmaceutical Price Regulation Scheme (PPRS). The PPRS sets maximum and minimum profit levels from the sale of branded drugs to the NHS. The PPRS allows companies freedom to set prices as they please on new substances, but restricts subsequent…