P4P program, also known as pay for performance, is a value-based payment model that attaches financial incentives, disincentives to the provider performance and is part of an overall national plan to transition health care to value-based medical interventions (Catalyst,2018). While the program uses the fee-for-service structure, it shoves care providers toward value-based care since it ties repayment to metric-driven results, best practices leading to patient satisfaction as it aligns value with quality.
Various P4P Program Results and Effectiveness
P4P programs are normally designed to offer financial recompenses or fines to individual healthcare providers, institutions or groups according to the output on quality measures. Results shows a well-coordinated P4P programs drives the conduct of care providers and systems to enhance value, reduction of unnecessary utilization of costly healthcare services and improves results. Pay-for-performance ideal is specifically important in the U.S. where broad and serious gaps in healthcare quality have been formulated in accordance to long-standing fee-for-service system. The earlier system only offers incentives for the volume of service rather than quality provided (Mendelson et.al, 2017).
Systematic evaluation of P4P shows that effectiveness of the program in America has mixed outcomes. It is connected to modest progress in process-of-care results but has slight impact on patienk outcomes. New payment system reward care providers for capitalizing on effects of preventive care, assisting in containment of exorbitant health care cost. The prevalent challenge of P4P implementation is getting all stakeholders agree on the quality of standard, since the superior standards are the ones that measures whether care providers are providing agreed thresholds. Besides P4P, improves care processes in ambulatory situations; however improved healthcare results have not been validated in any setting.
Strengths of P4P Compensation Method
Pay-for-Performance is normally described in the contest of reforms in the healthcare. The federal government is committed to fully implementation of the program into Medicare plan. Under the previous program of fee-for-service, physicians and health facilities are mostly motivated by financial incentives which may lead to over-utilization or over-prescription of health services. In the P4P program arrangement, the provider always attempt to enhance care they offer, commensurately with the great attention on quality. Physicians are rewarded handsomely for the quality service they provide which is a great motivation. When the program is merged with public quality reporting and other features of performance, P4P shows some elements of accountability for considerable funding providers obtain. The oversight may serve as a guide to patients and consumer in their choice of healthcare providers.
Weakness of P4P Compensation Method
Performance-for-pay introduces critical administrative complication related to acquisition of data and verification of its accuracy. Behavioral economics propose that professions requiring high cognitive proficiency and high intrinsic inspirations, associate good performance with monetary incentives. Therefore P4P might be counterproductive since there is a tendency of compromise to quality commitment. When incentives are used in a healthcare facility; it may or not impart the intrinsic motivation.
For clinicians, and care providers, there are fundamental gaps in what facets of care is quantifiable using the present data sources. Several P4P programs have a tendency to concentrate on clinical procedures measures instead of patient’s results, therefore there is tedious documentation of what have been done to the patient. Small incremental remuneration and fines imposed in the program may not be adequate to counter stronger incentives given in the base payment methods.