View Item 

Show simple item record

Long‐term care and pay‐for‐performance programs
dc.contributor.authorNorton, Edward C.
dc.date.accessioned2018-09-04T20:09:37Z
dc.date.available2019-09-04T20:15:39Zen
dc.date.issued2018-08
dc.identifier.citationNorton, Edward C. (2018). "Long‐term care and pay‐for‐performance programs." Review of Development Economics 22(3): 1005-1021.
dc.identifier.issn1363-6669
dc.identifier.issn1467-9361
dc.identifier.urihttps://hdl.handle.net/2027.42/145582
dc.description.abstractPay‐for‐performance programs are gradually spreading across Asia. This paper builds on the longer experience in the United States to offer lessons for Asia. The Center for Medicare and Medicaid Services has introduced several pay‐for‐performance programs since 2012 to encourage hospitals to improve quality of care and reduce costs. Some state Medicaid programs have also introduced pay‐for‐performance for nursing homes. Long‐term care providers play an important role in hospital pay‐for‐performance programs because they can affect the readmission rate and also total episode payments. A good pay‐for‐performance program will focus on improving quality of care that affects health outcomes. In addition, that quality must vary across providers and be measurable. Furthermore, it is important that the measures be reported in a timely way, that both demand and supply respond to the measures, and that the measures be risk adjusted. Empirical data from Medicare beneficiaries in the state of Michigan show that mean episode payments and readmission rates in skilled nursing facilities vary widely and are sensitive to the number of observations. These practical matters create challenges for implementing pay‐for‐performance in practice. There is an extensive literature review of pay‐for‐performance in long‐term care in the United States and in Asia.
dc.publisherWiley Periodicals, Inc.
dc.publisherEdward Elgar
dc.titleLong‐term care and pay‐for‐performance programs
dc.typeArticleen_US
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelEconomics
dc.subject.hlbtoplevelBusiness and Economics
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/145582/1/rode12359.pdf
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/145582/2/rode12359_am.pdf
dc.identifier.doi10.1111/rode.12359
dc.identifier.sourceReview of Development Economics
dc.identifier.citedreferenceRahman, M., Norton, E. C., & Grabowski, D. C. ( 2016 ). Do hospital‐owned skilled nursing facilities provide better post‐acute care quality? Journal of Health Economics, 50, 36 – 46.
dc.identifier.citedreferenceLee, T.‐T., Cheng, S.‐H., Chen, C.‐C., & Lai, M.‐S. ( 2010 ). A pay‐for‐performance program for diabetes care in Taiwan: A preliminary assessment. American Journal of Managed Care, 16 ( 1 ), 65 – 69.
dc.identifier.citedreferenceLi, Y.‐H., Tsai, W.‐C., Khan, M., Yang, W.‐T., Lee, T.‐F., Wu, Y.‐C., & Kung, P. T. ( 2010 ). The effects of pay‐for‐performance on tuberculosis treatment in Taiwan. Health Policy and Planning, 25 ( 4 ), 334 – 341.
dc.identifier.citedreferenceMaly, M. B., Lawrence, S., Jordan, M. K., Davies, W. J., Weiss, M. J., Deitrick, L., & Salas‐Lopez, D. ( 2012 ). Prioritizing partners across the continuum. Journal of the American Medical Directors Association, 13 ( 9 ), 811 – 816.
dc.identifier.citedreferenceMilstein, R., & Schreyoegg, J. ( 2016 ). Pay for performance in the inpatient sector: A review of 34 P4P programs in 14 OECD countries. Health Policy, 120 ( 10 ), 1125 – 1140.
dc.identifier.citedreferenceNorton, E. C. ( 1992 ). Incentive regulation of nursing homes. Journal of Health Economics, 11 ( 2 ), 105 – 128.
dc.identifier.citedreferenceNorton, E. C. ( 2000 ). Long‐term care. In A. J. Culyer & J. P. Newhouse (Eds.), Handbook of health economics (Vol. IB, pp. 956 – 994 ). New York, NY: Elsevier Science B.V.
dc.identifier.citedreferenceNorton, E. C., Kim, J., Das, A., & Chen, L. M. (in press). Moneyball in Medicare. Journal of Health Economics.
dc.identifier.citedreferenceRahman, M., Grabowski, D. C., Mor, V., & Norton, E. C. ( 2016 ). Is a skilled nursing facility’s rehospitalization rate a valid quality measure? Health Services Research, 51 ( 6 ), 2158 – 2175.
dc.identifier.citedreferenceSun, X., Liu, X., Sun, Q., Yip, W., Wagstaff, A., & Meng, Q. ( 2016 ). The impact of a pay‐for‐performance scheme on prescription quality in rural China. Health Economics, 25 ( 6 ), 706 – 722.
dc.identifier.citedreferenceWerner, R. M., Konetzka, R. T., & Liang, K. ( 2010 ). State adoption of nursing home pay‐for‐performance. Medical Care Research and Review, 67 ( 3 ), 364 – 377.
dc.identifier.citedreferenceWerner, R. M., Konetzka, R. T., & Polsky, D. ( 2013 ). The effect of pay‐for‐performance in nursing homes: Evidence from state Medicaid programs. Health Services Research, 48 ( 4 ), 1393 – 1414.
dc.identifier.citedreferenceWerner, R. M., Norton, E. C., Konetzka, R. T., & Polsky, D. ( 2012 ). Do consumers respond to publicly reported quality information? Evidence from nursing homes. Journal of Health Economics, 31 ( 1 ), 50 – 61.
dc.identifier.citedreferenceWerner, R. M., Skira, M., & Konetzka, R. T. ( 2016 ). An evaluation of performance thresholds in nursing home pay‐for‐performance. Health Services Research, 51 ( 6 ), 2282 – 2304.
dc.identifier.citedreferenceYip, W., Powell‐Jackson, T., Chen, W., Hu, M., Fe, E., Hu, M., … Hsiao, W. C. ( 2014 ). Capitation combined with pay‐for‐performance improves antibiotic prescribing practices in rural China. Health Affairs, 33 ( 3 ), 502 – 510.
dc.identifier.citedreferenceBriesacher, B. A., Field, T. S., Baril, J., & Gurwitz, J. H. ( 2009 ). Pay‐for‐performance in nursing homes. Health Care Financing Review, 30 ( 3 ), 1 – 13.
dc.identifier.citedreferenceBurwell, S. M. ( 2015 ). Setting value‐based payment goals—HHS efforts to improve U.S. health care. New England Journal of Medicine, 372 ( 10 ), 897 – 899.
dc.identifier.citedreferenceChang, R.‐E., Li, S.‐P., & Aron, D. C. ( 2012 ). A pay‐for‐performance program in Taiwan improved care for some diabetes patients, but doctors may have excluded sicker ones. Health Affairs, 31 ( 1 ), 93 – 102.
dc.identifier.citedreferenceChen, L. M., Norton, E. C., Banerjee, M., Regenbogen, S. E., Cain‐Nielsen, A. H., & Birkmeyer, J. D. ( 2017 ). Spending on care after surgery driven by choice of care setting instead of intensity of services. Health Affairs, 36 ( 1 ), 83 – 90.
dc.identifier.citedreferenceDas, A., Norton, E. C., Miller, D. C., Ryan, A. M., Birkmeyer, J. D., & Chen, L. M. ( 2016 ). Adding a spending metric to Medicare’s value‐based purchasing program rewarded low‐quality hospitals. Health Affairs, 35 ( 5 ), 898 – 906.
dc.identifier.citedreferenceGrabowski, D. C., & Norton, E. C. ( 2012 ). Nursing home quality of care. In A. M. Jones (Ed.), The Elgar companion to health economics ( 2nd ed., ch. 29, pp. 307 – 317 ). Northampton, MA: Edward Elgar.
dc.identifier.citedreferenceGrabowski, D. C., Stephenson, D. G., Caudry, D. J., O’Malley, A. J., Green, L. H., Doherty, J. A., & Frank, R. G. ( 2017 ). The impact of nursing home pay‐for‐performance on quality and medicare spending: Results from nursing home value‐based purchasing demonstration. Health Services Research, 52 ( 4 ), 1387 – 1408.
dc.identifier.citedreferenceHanaoka, C., & Norton, E. C. ( 2008 ). Informal and formal care for elderly persons: How adult children’s characteristics affect the use of formal care in Japan. Social Science & Medicine, 67 ( 6 ), 1002 – 1008.
dc.identifier.citedreferenceIizuka, T., Noguchi, H., & Sugawara, S. ( 2017 ). Pay‐for‐performance for long‐term care (Working Paper). University of Tokyo.
dc.identifier.citedreferenceInoue, Y., Jeong, S., & Konto, K. ( 2011 ). Changes in hospital performance after implementation of pay‐for‐performance in Japan. Clinical Audit, No. 3, 17 – 23.
dc.identifier.citedreferenceJeong, S., Katsunori, K., Shiraishi, N., & Yusuke, I. ( 2010 ). An evaluation of the quality of post‐stroke rehabilitation in Japan. Clinical Audit, No. 2, 59 – 66.
dc.identifier.citedreferenceKonetzka, R.T., Skira, M., & Werner, R. M. (in press). Incentive design and quality improvements: Evidence from state Medicaid nursing home pay‐for‐performance programs. American Journal of Health Economics.
dc.identifier.citedreferenceLage, D. E., Rusinak, D., Carr, D., Grabowski, D. C., & Ackerly, D. C. ( 2015 ). Creating a network of high‐quality skilled nursing facilities: Preliminary data on the post‐acute care quality improvement experiences of an accountable care organization. Journal of the American Geriatric Society, 63 ( 4 ), 804 – 808.
dc.identifier.citedreferenceLee, J. Y., Lee, S.‐I., Kim, N.‐S., Kim, S.‐H., Son, W.‐S., & Jo, M.‐W. ( 2012 ). Healthcare organizations’attitudes toward pay‐for‐performance in Korea. Health Policy, 108 (2‐3), 277 – 285.
dc.owningcollnameInterdisciplinary and Peer-Reviewed


Files in this item

Name:
rode12359.pdf
Size:
344.7KB
Format:
PDF
View/Open
Name:
rode12359_am.pdf
Size:
1.335MB
Format:
PDF
View/Open

Show simple item record

Remediation of Harmful Language

The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.

Accessibility

If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.