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Pay-for-performance programs effectiveness in healthcare: the case of the end-stage renal disease quality incentive program

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  • Saeed Piri

    (Lundquist College of Business, University of Oregon)

Abstract

This paper focuses on Medicare’s End-Stage Renal Disease Quality Incentive Program (QIP). QIP aims to promote high-quality services in outpatient dialysis facilities by tying their payments to their performance on pre-specified quality measures. In this paper, employing principal-agent theory, we examine the effectiveness of QIP by exploring the changes in various clinical/operational measures when they become a part of the program as a performance measure. We study five QIP quality measures; two are operational: hospitalization and readmission. And three others are clinical: blood transfusion, hypercalcemia, and dialysis adequacy. Overall, we observe a significant improvement in all QIP quality measures after being included in the program, except for readmission. We recommend adjusting the weight and redesigning the readmission measure for Medicare to incentivize providers to reduce readmission. We also discuss establishing care coordination and employing data-driven clinical decision support systems as opportunities for dialysis facilities to improve the care delivery process.

Suggested Citation

  • Saeed Piri, 2024. "Pay-for-performance programs effectiveness in healthcare: the case of the end-stage renal disease quality incentive program," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(2), pages 221-236, March.
    • Handle: RePEc:spr:eujhec:v:25:y:2024:i:2:d:10.1007_s10198-023-01582-x
    DOI: 10.1007/s10198-023-01582-x
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    References listed on IDEAS

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    1. Donald K. K. Lee & Stefanos A. Zenios, 2012. "An Evidence-Based Incentive System for Medicare's End-Stage Renal Disease Program," Management Science, INFORMS, vol. 58(6), pages 1092-1105, June.
    2. Puri, Manju & Rocholl, Jörg & Steffen, Sascha, 2011. "Global retail lending in the aftermath of the US financial crisis: Distinguishing between supply and demand effects," Journal of Financial Economics, Elsevier, vol. 100(3), pages 556-578, June.
    3. David E. M. Sappington, 1991. "Incentives in Principal-Agent Relationships," Journal of Economic Perspectives, American Economic Association, vol. 5(2), pages 45-66, Spring.
    4. Joseph White, 2019. "Can performance measurement make health care systems more sustainable? Or at least more efficient?," OECD Journal on Budgeting, OECD Publishing, vol. 19(3).
    5. David Dreyfus & Anand Nair & Srinivas Talluri, 2020. "The Impact of Chain Organization Size on Efficiency and Quality of Affiliated Facilities—Implications for Multi‐Unit Organizational Forms," Production and Operations Management, Production and Operations Management Society, vol. 29(7), pages 1605-1623, July.
    6. Brad N. Greenwood & Ritu Agarwal, 2016. "Matching Platforms and HIV Incidence: An Empirical Investigation of Race, Gender, and Socioeconomic Status," Management Science, INFORMS, vol. 62(8), pages 2281-2303, August.
    7. Robert G. Fichman & Rajiv Kohli & Ranjani Krishnan, 2011. "Editorial Overview ---The Role of Information Systems in Healthcare: Current Research and Future Trends," Information Systems Research, INFORMS, vol. 22(3), pages 419-428, September.
    8. Fainman, Emily Zhu & Kucukyazici, Beste, 2020. "Design of financial incentives and payment schemes in healthcare systems: A review," Socio-Economic Planning Sciences, Elsevier, vol. 72(C).
    9. Jiayi Liu & Anandhi Bharadwaj, 2020. "Drug Abuse and the Internet: Evidence from Craigslist," Management Science, INFORMS, vol. 66(5), pages 2040-2049, May.
    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    Healthcare payment; Pay-for-performance; Empirical; Health economy; Dialysis facilities;
    All these keywords.

    JEL classification:

    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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