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• W2008939667 abstract "No AccessJournal of UrologyReview article1 Aug 2007Pay for Performance: Rationale and Potential Implications for Urology Chris M. Gonzalez, David Penson, Beth Kosiak, James Dupree, and J. Quentin Clemens Chris M. GonzalezChris M. Gonzalez Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author , David PensonDavid Penson Department of Urology, University of Southern California School of Medicine, Los Angeles, California More articles by this author , Beth KosiakBeth Kosiak American Urological Association, Linthicum, Maryland More articles by this author , James DupreeJames Dupree Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author , and J. Quentin ClemensJ. Quentin Clemens Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.03.095AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Pay for performance represents a new paradigm for physician reimbursement based on the value based purchasing of health care services. Government and private payers have expressed an interest in moving toward this system with several pay for performance programs already in place. The rationale behind this initiative and what it means for the practicing urologist are discussed. Materials and Methods: MEDLINE® and Internet based research focusing on the topics of health care quality, measures used to implement pay for performance, and private and public sector experience with pay for performance to date were reviewed. Results: Health care quality can be assessed through 3 types of measures, including structure, process and outcome. Structure measures involve the environment where services are provided, whereas process measures capture how a particular provider delivers health care. Outcome assessment involves the results of the services provided. These measures are best used when they are used in coordination with each other, and when they are risk adjusted. Most pay for performance systems in use today are based on these measures. However, there are little data that show whether this reimbursement paradigm actually improves the quality of heath care provided. Conclusions: Many questions remain regarding the implementation of a pay for performance system in the field of urology. Government and private payers are motivated to implement pay for performance. However, specific evidence based metrics for urology that fairly and accurately define quality are currently lacking. Given that implementation of a nationwide pay for performance system appears to be inevitable, urology involvement in the development and implementation of these health care quality metrics is essential. References 1 : To Err is Human: Building a Safer Health System. Washington, D. C: National Academy Press1999. Google Scholar 2 : Pay-for-performance: what can you expect?. J Fam Pract2005; 54: 609. Google Scholar 3 : Change in the quality of care delivered to Medicare beneficiaries, 1998–1999 to 2000–2001. JAMA2003; 289: 305. Google Scholar 4 : Linking compensation to quality—Medicare payments to physicians. N Engl J Med2005; 353: 870. Google Scholar 5 : An Inquiry into the Nature and Causes of the Wealth of Nations. London: Methuen and Co1904. Google Scholar 6 : Five years after To Err Is Human: what have we learned?. JAMA2005; 293: 2384. Google Scholar 7 : An evidence-based national quality measurement and reporting system. Med Care2003; 41: I8. 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Google Scholar 22 Green E: Use of Electronic Records Growing Slowly. Available at www.msnbc.msn.com/id/11805458. Accessed March 12, 2006. Google Scholar 23 The Commonwealth Fund: Physicians Slow to Adopt Health Information Technology Cost Remains Biggest Barrier to Diffusion, Says Study. IT Use Highly Dependant on Size of Medical Practice and Mode of Compensation. Available at www.cmwf.org/newsroom/newsroom_show.htm. Accessed March 12, 2006. Google Scholar 24 : Electronic Medical Records: A Guide for Clinicians and Administrators. Philadelphia: American College of Physicians2001. Google Scholar 25 : Quality-of-care indicators for early-stage prostate cancer. J Clin Oncol2003; 21: 1928. Google Scholar 26 : Risk adjustment of the postoperative mortality rate for the comparative assessment of the quality of surgical care: results of the National Veterans Affairs Surgical Risk Study. J Am Coll Surg1997; 185: 315. 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Google Scholar 31 : The comparative assessment and improvement of quality of surgical care in the Department of Veterans Affairs. Arch Surg2002; 137: 20. Google Scholar 32 : Measuring the quality of care for localized prostate cancer. J Urol2005; 174: 425. Link, Google Scholar 33 : What is the empirical basis for paying for quality in health care?. Med Care Res Rev2006; 63: 135. Google Scholar 34 : Early experience with pay-for-performance: from concept to practice. JAMA2005; 294: 1788. Google Scholar 35 Centers for Medicare and Medical Services: Physician Voluntary Reporting Progress—Overview. Available at www.cms.hhs.gov/PVRP/. Accessed February 14, 2006. Google Scholar 36 : A. M. A. to Develop Measure of Quality of Medical Care. : 2006. New York Times, February 21,. Google Scholar © 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byMossanen M, Ingham M, Leow J, Tinay I, Wang Y, Krasnow R, Preston M, Bellmunt J, Chung B, Rosenberg J and Chang S (2017) Exploring Patterns of Mitomycin C Use in Community Practice UrologyUrology Practice, VOL. 5, NO. 1, (7-14), Online publication date: 1-Jan-2018.Breyer B, Fang R, Meeks W, Lightner D and Clemens J (2016) Use of the American Urological Association Clinical Practice Guidelines: Data from the AUA CensusUrology Practice, VOL. 4, NO. 6, (462-467), Online publication date: 1-Nov-2017.Penson D (2014) Re: Variation in Surgical-Readmission Rates and Quality of Hospital CareJournal of Urology, VOL. 191, NO. 5, (1363-1364), Online publication date: 1-May-2014.Dahm P, Yeung L, Gallucci M, Simone G and Schünemann H (2008) How to Use a Clinical Practice GuidelineJournal of Urology, VOL. 181, NO. 2, (472-479), Online publication date: 1-Feb-2009.Dahm P, Poolman R, Bhandari M, Fesperman S, Baum J, Kosiak B, Carrick T and Preminger G (2008) Perceptions and Competence in Evidence-Based Medicine: A Survey of the American Urological Association MembershipJournal of Urology, VOL. 181, NO. 2, (767-777), Online publication date: 1-Feb-2009. (2008) Reply by AuthorsJournal of Urology, VOL. 180, NO. 2, (460-460), Online publication date: 1-Aug-2008. Volume 178Issue 2August 2007Page: 402-408 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsaccessreimbursementhealthcare qualityurologyincentiveand evaluationoutcome and process assessment (health care)MetricsAuthor Information Chris M. Gonzalez Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author David Penson Department of Urology, University of Southern California School of Medicine, Los Angeles, California More articles by this author Beth Kosiak American Urological Association, Linthicum, Maryland More articles by this author James Dupree Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author J. Quentin Clemens Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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