title: Quality- and severity-based payment: will you receive what you earn?
abstract: Pay-for-performance programs that call for healthcare providers to meet external quality metrics are being proposed by the Centers for Medicare and Medicaid Services and other payers in order to increase the value of dollars spent on health care. While linking payment with the quality of health care may be a laudable goal, such programs have the potential to test the relationships between hospitals and physicians and unfairly penalize hospitals for factors that are beyond their control. In the following article, HFMA, with sponsorship from 3M Health Information Systems, asks five industry leaders to share their thoughts about what pay-for-performance programs may entail, how these programs and severity-based payment adjustments may affect their healthcare facilities, and strategies healthcare organizations should employ to best prepare.
authors.affiliation: Nemaha County Hospital, Nebraska, USA.
authors.forename: Mandy Lynn
authors.initials: ML
authors.lastname: Price
authors.forename: Kirk W
authors.initials: KW
authors.lastname: Strack
authors.forename: Deborah K
authors.initials: DK
authors.lastname: Weymouth
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Yates
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Rothermich
mesh_terms: D006801:Humans; D010820:Physicians / Q000191:economics*; D011787:Quality of Health Care; D012051:Reimbursement Mechanisms; D012720:Severity of Illness Index; D014481:United States