Health Services Research & Development

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Challenges and Opportunities for Pay-for-Performance as Veteran Care Moves into the Community

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ESP Report: Challenges and Opportunities for Pay-for-Performance as Veteran Care Moves into the Community

Prepared by:
Evidence-based Synthesis Program (ESP) Portland VA Health Care System Portland, OR
Devan Kansagara, MD, MCR, Director

Recommended citation:
Kondo K, Wyse J, Mendelson A, Beard G, Low A, Freeman M, Kansagara D. Challenges and Opportunities for Pay-for-performance as Veteran Care Moves into the Community. VA ESP Project #05-225; 2017.



Download PDF: Complete Report, Executive Summary, Report, Appendices



Introduction

Pay-for-performance (P4P) is commonly used in the Veterans Health Administration (VHA) system, and is expected to be an important strategy to incentivize quality and appropriate utilization as Veteran care moves into the community. The purpose of the current project is to 1) assess the effects of pay-for-performance programs on the quality of care and health of Veterans, 2) identify potential unintended consequences of pay-for-performance programs targeting Veteran health, 3) identify performance metrics that have been incentivized in published P4P literature, 4) identify the program design features and implementation factors that might modify the effectiveness of P4P targeting Veteran populations, both in VHA settings and in the community, and 5) identify novel P4P approaches in VHA settings and Veterans Affairs (VA)-funded research examining P4P or related program features or implementation factors.

Key Questions

Key Question 1. What are the effects of pay-for-performance programs on the quality of care and health of Veterans?

Key Question 2. In Veteran populations, what are the potential unintended consequences of pay-for-performance in healthcare?

Key Question 3. What metrics have been commonly incentivized in published literature examining P4P?

Key Question 4. In Veteran populations, what program features and implementation factors modify the effectiveness of pay-for-performance programs?

Key Question 5. What novel approaches and/or current or recently closed research projects funded by VA examine the effectiveness, implementation factors, or unintended consequences associated with pay-for-performance in Veteran populations?

See also

Pay-for-Performance as Veteran Care Moves into the Community (Management eBrief)

Kondo K, Wyse J, Mendelson A, et al. Pay-for-Performance and Veteran Care in the VHA and the Community: a Systematic Review. Journal of General Internal Medicine. 2018;33(7):1155-1166. https://doi.org/10.1007/s11606-018-444-4