Driven by skyrocketing health care costs, public reporting of systemic quality issues, and increased employer pressure through groups like Leapfrog and others, pay for performance is rapidly becoming a $100 million trend in the United States. This movement to provide better value to both payers and consumers of health care isn't just an issue for physicians anymore; hospitals are now under performance scrutiny as reimbursement is being increasingly linked to quality patient outcomes.

What began in the 1990s as a grass roots campaign to curb rising health care costs by establishing a correlation between quality performance and reimbursement has turned into a congressionally-mandated reimbursement standard to be implemented by the Centers for Medicare and Medicaid (CMS) by 2009.

We invite you to download Risk Management Implications of Pay for Performance, a publication of Marsh's HealthCare Practice that discusses the potential financial impact the P4P initiative will have on health care providers and payers, how consumer influence factors into the implementation of and adherence to quality measures, and what health care industry executives can do to find the upside in pay for performance.

Additional Information:

CMS Performance Measurement Schedule (core measures) – Centers for Medicare and Medicaid

Never Events – The National Quality Forum

Guidelines for Pay-for-Performance Programs – American Medical Association (AMA)

Principles for Pay-for-Performance Programs – AMA

ACCF Principles to Guide Physician Pay-for-Performance Programs For the delivery of Cardiovascular Care – American College of Cardiology Foundation

Pay for Performance: Improving Quality and Efficiency of Healthcare Delivery – Plexis Healthcare Systems

Inside the Premier/CMS Pay-for-Performance Project – Hospitals & Health Networks

Paying for Performance — Risks and Recommendations – The New England Journal of Medicine

Rewarding Provider Performance: Aligning Incentive in Medicare – Institute of Medicine (report brief)

CRS Report for Congress: Pay-for-Performance in Health Care – Congressional Research Service, The Library of Congress