Merit-Based Incentive Payment

Throughout history there have been many acts and guidelines created to try and improve quality of care. MACRA falls into this category of an act that tries to enhance the quality of care for patients under Medicare. Harry A. Sultz and Kristina M. Young, the authors of Health Care USA Understanding Its Organization and Delivery, write that quality was defined as “the degree of conformity with preset standards.” (p. 140) The new definition of quality that Harry A. Sultz and Kristina M. Young write characterizes the quality of a provider’s care as the degree to which the care delivered increases the likelihood of desired patient outcomes and reduces the likelihood of undesired outcomes. (p. 144-145) MACRA was signed into law to try and lead to better patient outcomes by paying physicians based on whether their services are successful or not. The new definition focuses on increasing desired patient outcomes and reducing undesired patient outcomes, and this relates to MACRA because MACRA tries to improve patient outcomes and tries to promote more successful treatments. Another relevant, but more specific course concept would be the Accountable Care Organization (ACO) model. Harry A. Sultz and Kristina M. Young write that the ACO payment structure shifts the orientation of patient care from a series of fee-for-service reimbursed interventions toward financial reward for maintaining patients’ health. (p.

Championing a cause is a beautiful way for ordinary citizens to be involved in political activism. The modern party activist is more likely to be driven by purposive incentives than ever. This switch away from material and social incentives, driven by an increased awareness of social issues, has allowed party lines to blur in a way that has improved America's political sphere, and has allowed the increased participation of citizens in the democratic process.

Constance, evidenced based practice (EBP) and quality are important and they are becoming a focus of healthcare payment models that reward for better quality and outcomes. With the repeal of the Sustainable Growth Rate (SGR) legislature and the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, the United States has changed the rules around what determines how much health care providers are paid for services. Starting in 2019, providers including physicians and advanced practice nurses (APNs), will receive payments that are adjusted by the cost associated with, and the quality outcomes of the care provided to their patients for services rendered during 2017 (MACRA, 2015). It is important that all care providers

(Shutterstock Image ID=570593830 --- Alt. Text: MACRA Implementation --- Caption: MACRA Implementation has created specific hurdles that must be overcome to promote physician participation in the merit-based payment program.)

The reimbursement method I will be discussing is the Pay-For-Performance, which is this method that provides financial incentives to medical facilities and healthcare providers to make specific improvements and/or achieve outstanding outcomes for patients. For example physicians can receive bonuses for meeting set goals for the facility such as minimizing reoccurring preventable medical issues in certain population of patients. The CMS established 4 quality measures (process measures, outcomes measures, patient measures, and structure measures) to assess the performance of providers and medical facilities and also includes penalties for poor performance. One of the quality measures (patient measures) gives the “power” back to the consumer

My first week at ACS was very exciting. I met a lot people and was introduced into the new changes pertaining to the quality payment program (QPP) that came into effect this year. I learned that the physicians’ quality reporting system (PQRS) along with the EHR incentive and value modifiers are being consolidated under Merit-based Incentive Payment System (MIPS). The Medicare & CHIP Reauthorization Act of 2015 (MACRA) created two tracks, MIPS and Advanced Alternative Payment Models (APMs). The goal of MACRA is to improve overall quality of care, reduce medical errors, eliminate redundancy, and improvement of health. Health care entities have the option to comply with one or the other. These entities include physicians, nurse practitioners,

I feel MACRA will be great improvement when comes to payments for physicians who provides high quality care. It seems to be straight forward and the physicians have more ability to choose which path they want, based on what is more relevant to their practice. It also allows CMS to reward exceptional performance by ten percent.However, it will affect small practices because they don’t qualify for MIPS because they don’t provide as much care to Medicare

Small State University is facing the dilemma of how to allocate the $17,400 that the state agreed to give to the management department. Each qualified candidate’s employment information is given to help determine the merit raise decision. Before the decision can finalize, research and analysis will be conducted. A case solution will include the implementation of management approval, budget recommendations, communication and essential steps of the new policy to the university, and fair distribution of merit raise.

Payments models will continue to change in 2016 and in order to get paid what they deserve, physicians will have to prepare to take on more risk. When Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) in April, providers across the country breathed a sigh of relief. It wasn’t long, however, until doctors realized that solution came with a price: incentives to move away from the old fee-for-service payment model toward quality-of-care models for Medicare payments.

In my experience, the hardest situation for me to control is having performance goals that I do not directly control. For example, one of my performance goals is safety, which is extremely important within my organization and a large percentage of my yearly incentive check is based on how safe my company is as a whole. Obviously I can control how safe I am, and have a high degree of control with my own employees, however, there are employees in other locations that report to someone else, but they can have an effect on the amount my incentive check will be. Our company safety objectives affect everyone’s incentive check, either positively or negatively.

Incentives are a great way to motivate employees to partake in wellness initiatives. Employees want to know that there will be a guaranteed gain for their participation. However, there are a number of laws and regulations at the federal and state level that impose requirements and regulate the use of financial incentives in certain types of wellness programs. The reward must be available to all similarly situated individuals. For instance, Weisberg (2013) explained that the program must allow a reasonable alternative standard (or waiver of initial standard) for obtaining the reward to any individual for whom it is unreasonably difficult due to a medical condition, or medically inadvisable, to satisfy the initial standard. As a result, employers

Let people do their best work, even in difficult circumstances; it is one of the most slippery

Several pay and reward strategies can be adopted by organisations. However, each of the strategies involves issues that must be considered as it could affect the employees and the organisation. Therefore, it is vital that each organisation implement and develop certain pay and reward strategies, which are aligned with its own business strategies. This will ensure that perspectives of employees, employers and the costs are all considered in the course of the application of each strategy. The aim of this essay is to explain and evaluate the main pay and reward strategies adopted by organisations as well as the benefits and disadvantages of each. Graded pay, broad-banding graded-pay, labour-market-related pay, performance related pay and total reward which includes financial and non-financial rewards will all be explained in detail and evaluated as well as the benefits and drawbacks of each.

The question I would like to research is the feasibility of merit-based compensation in the public sector: opportunities and limitations. I would like to explore merit-based compensation systems in public organizations, their effect on performance and motivation of employees, and analyze the factors that may provide limitations to the performance-based compensation in the public sector.

‘Financial rewards and incentives should be used to motivate employees’. Critically evaluate. Employee motivation is considered to be an important component of an organization to accomplish its objectives successfully. Managers use tools like financial as well as non-financial rewards and incentives to increase motivation. While financial rewards are generally considered to be beneficial, non-financial rewards also have an important role to play because of their impact on different types of motivation such as intrinsic and extrinsic.