Paying for Quality Not Quantity: A Wisconsin Health Maintenance Organization Proposes an Incentive Model for Reimbursement of Chiropractic Services

Pursel, Kevin J.; Jacobson, Martin; Stephenson, Kathy

doi:10.1016/j.jmpt.2012.07.003

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…[ 5 ] With the affordable health care law firmly in place, the concept of fee-for-value reimbursement has gained more attention. [ 6 7 8 ] It is demonstrated that a model whereby the same group of anesthesiologists are utilized to provide services involving repetitive tasks like endoscopy anesthesia services saves costs. [ 9 ] However, all physicians are not equally efficient in providing skill based services.…”

Section: Discussionmentioning

confidence: 99%

Effect of introduction of a new electronic anesthesia record (Epic) system on the safety and efficiency of patient care in a gastrointestinal endoscopy suite-comparison with historical cohort

et al. 2016

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Background:Use of electronic medical record systems has increased in the recent years. Epic is one such system gaining popularity in the USA. Epic is a private company, which invented the electronic documentation system adopted in our hospital. In spite of many presumed advantages, its use is not critically analyzed. Some of the perceived advantages are increased efficiency and protection against litigation as a result of accurate documentation.Materials and Methods:In this study, retrospective data of 305 patients who underwent endoscopic retrograde cholangiopancreatography (wherein electronic charting was used - “Epic group”) were compared with 288 patients who underwent the same procedure with documentation saved on a paper chart (“paper group”). Time of various events involved in the procedure such as anesthesia start, endoscope insertion, endoscope removal, and transfer to the postanesthesia care unit were routinely documented. From this data, the various time durations were calculated.Results:Both “anesthesia start to scope insertion” times and “scope removal to transfer” times were significantly less in the Epic group compared to the paper group. Use of Epic system led to a saving of 4 min of procedure time per patient. However, the mean oxygen saturation was significantly less in the Epic group.Conclusion:In spite of perceived advantages of Epic documentation system, significant hurdles remain with its use. Although the system allows seamless flow of patients, failure to remove all artifacts can lead to errors and become a source of potential litigation hazard.

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Section: Discussionmentioning

confidence: 99%

Effect of introduction of a new electronic anesthesia record (Epic) system on the safety and efficiency of patient care in a gastrointestinal endoscopy suite-comparison with historical cohort

et al. 2016

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“…Some of the important ones are discussed in the subsequent sections. Pursel et al (2012) described a reimbursement model that was developed by Health Maintenance Organization to transit from a fee-for-service to add a combination of pay for performance and reporting model of reimbursement for chiropractic care. Atak and Kingma (2011) carried out a study to decode the inner working mechanism of safety culture in aircraft maintenance and to understand this culture as the outcome of wider organizational processes.…”

Section: Introductionmentioning

confidence: 99%

Continuous improvement of maintenance process for the cement industry – a case study

Shafeek

2014

Journal of Quality in Maintenance Engineering

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Purpose – The purpose of this paper is to describe the most important areas of maintenance management system for heavy industries for helping maintenance mangers to focus on measuring the effectiveness of maintenance system. This work aimed at inferring relationships between maintenance management, maintenance practices and maintenance improvement. Design/methodology/approach – In relation to maintenance management, as a case study approach, it can be applied to continuous improvement maintenance systems through 15 maintenance process areas. Findings – The general picture evidences some criticalities, such as those areas which help in the success of maintenance management and areas which lead to the failure of maintenance management. It was found that by using the maintenance management system in the cement industry, it was possible to measure and improve about 15 percent maintenance performance which can be achieved by enhancing maintenance in the suggested areas. Practical implications – Continuous maintenance improvement (CMI) is an ongoing effort to improve maintenance aimed at maintenance process simplification and reduction or elimination of maintenance process waste. To support CMI, maintenance engineers continually examine maintenance processes to discover and eliminate problems. Originality/value – Other researchers have reported on the maintenance management system, but most of them have focussed on limited areas. The lack of useful and practical research has been determined. It seems that the scientific knowledge of maintenance management still needs more effort. This study is one of the first in-depth studies into actual condition-based maintenance practice to test 15 maintenance process areas.

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“…It is understood that insurance companies in the United States are a part of the P4P system in many programs that encourage them to reduce their expenses. As an example, for reducing the long-term costs of patients with chronic back pain, programs in which the adaptation of patients is controlled with regular doctor visits are heavily sponsored (9). In addition, the pay for performance system is partially implemented in many countries of The Organization for Economic Co-operation and Development (OECD), EU member countries, Asian and African countries (1).…”

mentioning

confidence: 99%

Pay for performance system in Turkey and the world; a global overview

Şahiner

Esen²,

Uçar³

et al. 2022

Turk J Surg

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Objective: This study aimed to compare the pay for performance system applied nationally in Turkey and in other countries around the world and to reveal the effects of the system applied in our country on the general surgery. Material and Methods: Current literature and countries’ programs on the implementation of the pay for performance system were recorded. The results of the Turkish Surgical Association’s performance and Healthcare Implementation Communique (HIC) commission studies were evaluated in light of the literature. Results: Many countries have implemented performance systems on a limited scale to improve quality, speed up the diagnosis, treatment, and control of certain diseases, and they have generally applied it as a financial promotion by receiving the support of health insurance companies and nongovernmental organizations. It turns out that surgeons in our country feel that they are being wronged because of the injustice in the current system because the property of their works is not appreciated and they cannot get the reward for the work they do. This is also the reason for the reluctance of medical school graduates to choose general surgery. Conclusion: Authorities should pay attention to the opinions of associations and experts in the related field when creating lists of interventional procedures related to surgery. Equal pay should be given to equal work nationally, and surgeons should be encouraged by incentives to perform detailed, qualified surgeries. There is a possibility that the staff positions opened for general surgery, as well as, all surgical branches will remain empty in the near future.

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Paying for Quality Not Quantity: A Wisconsin Health Maintenance Organization Proposes an Incentive Model for Reimbursement of Chiropractic Services

Cited by 3 publications

References 7 publications

Effect of introduction of a new electronic anesthesia record (Epic) system on the safety and efficiency of patient care in a gastrointestinal endoscopy suite-comparison with historical cohort

Effect of introduction of a new electronic anesthesia record (Epic) system on the safety and efficiency of patient care in a gastrointestinal endoscopy suite-comparison with historical cohort

Continuous improvement of maintenance process for the cement industry – a case study

Pay for performance system in Turkey and the world; a global overview

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