Paying For Performance May Improve The Quality of Medical Care

P4P is a revolutionary method of figuring medical billing payments. The Centers for Medicare & Medicaid Services has announced that the method of “paying for performance” works to improve the quality of a patient’s care. The current medical billing demonstration that took place had encouraging results for CMS.

The areas in which the pay for performance method has been shown to improve the most care is with pneumonia, hip and knee replacements, and heart care. These improvements of care were shown in the first year of the trial run. Only certain hospitals took part in this medical billing study. In the second year of the trial, the quality of care continued to improve.

When the Centers for Medicare & Medicaid Services pay based on performance, it means that patients overall receive less complications than the previous years. This means better health and less medical billing payouts to be made.

The Centers for Medicare & Medicaid Services are extremely excited about this finding. They are awarding $8.85 million to the hospitals that had significant improvements in the first year of the medical billing study. Once the third year of the program rolls around, the Centers for Medicare & Medicaid Services has decided they will begin to reduce the payments to the low performance hospitals. Right now they are sticking to positive reinforcement, but later they will move to negative reinforcement.

Some providers look at the pay for performance payment method as a negative change. In fact, this is good news for patients. It means that doctors and hospitals will always have our best interests in mind because they have their best interests in mind. Hospital care shouldn’t always be about medical billing, but this way, medical billing won’t get in the way of your health.

View all Articles by: Melissa Clark, CCS-P