Why do P4P programs will remain a fixture in U.S. healthcare for the foreseeable future if research shows that these programs have not had the desired impact on improving care?

Mendelson, A., Kondo, K., Damberg, C., Low, A., Motúapuaka, M., Freeman, M., O’Neil, M., Relevo, R., & Kansagara, D. (2017). The effects of pay-for-performance programs on health, health care use, and the processes of care: A systematic review. Annals of Internal Medicine, 166(5). 341–353.

Read the Mendelson, et al. article.

The article states:

In summary, we found low-strength, contradictory evidence that P4P programs could improve processes of care, but we found no clear evidence to suggest that they improve patient outcomes. Value-based purchasing is a cornerstone of the coming Medicare reform known as the Medicare Access and CHIP Reauthorization Act, so P4P will remain a fixture in U.S. health care for the foreseeable future (94). Whether the inconsistency of positive findings suggests that P4P, broadly speaking, is unlikely to have large effects or is related to the marked differences in program design, patient population, and incentive target is unclear. (p. 350) 

Please answer questions 1-3

1.Why do you think P4P programs will remain a fixture in U.S. healthcare for the foreseeable future if research shows that these programs have not had the desired impact on improving care?

2.Use examples from your clinical practice setting, long-term care/nursing home to support your position.

3.How would your role as a nurse leader impact regulatory required P4P programs within your clinical practice setting? 

References

1. Chapters 2 and 3 in Penner, Susan. (2017). Economics and financial management for nurses and nurse leaders (7th ed). Springer Publishing Company.

2.  Mendelson, A., Kondo, K., Damberg, C., Low, A., Motúapuaka, M., Freeman, M., O’Neil, M., Relevo, R., & Kansagara, D. (2017). The effects of pay-for-performance programs on health, health care use, and the processes of care: A systematic review. Annals of Internal Medicine, 166(5). 341–353.

3.  Kaplan, R. S., & Porter, M. E. (2011). How to solve the cost crisis in health care. Harvard Business Review, 89(9), 46–63. (Available through EBSCO)

4.Sommers, B. D., Maylone, B., Blendon, R. J., Orav, E. J., & Epstein, A. M.  (2017). Three-year impacts of the Affordable Care Act: Improved medical care and health among low-income adults. Health Affairs, 36(6 ), 1119–1128. (Available through Proquest)