The role of pay-for-performance in reducing healthcare disparities: A narrative literature review

Conway, Alex; Satin, David J

doi:10.1016/j.ypmed.2022.107274

Cited by 5 publications

(4 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Notably, value‐based insurance design (VBID) is a model in which insurers reduce cost‐sharing for targeted, high‐value services (such as chronic disease management services for patients with diabetes). 35 AHRQ could contribute to research into whether VBID or similar reforms improve access and outcomes for specific populations, such as people with lower incomes. AHRQ could also contribute to research to refine the definition of high‐value versus low‐value care, especially for services and procedures that differ in value depending on the context.…”

Section: Discussionmentioning

confidence: 99%

“…Patient cost barriers to careInsurers have attempted some experiments in adjusting patient costsharing to encourage better access. Notably, value-based insurance design (VBID) is a model in which insurers reduce cost-sharing for targeted, high-value services (such as chronic disease management services for patients with diabetes) 35. AHRQ could contribute to research into whether VBID or similar reforms improve access and outcomes for specific populations, such as people with lower incomes.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The role of payment and financing in achieving health equity

Eschliman,

Pham,

Navathe

et al. 2023

Health Services Research

View full text Add to dashboard Cite

ObjectiveThe aim was to identify healthcare payment and financing reforms to promote health equity and ways that the Agency for Healthcare Research and Quality (AHRQ) may promote those reforms.Data Sources and Study SettingAHRQ convened a payment and financing workgroup–the authors of this paper–as part of its Health Equity Summit held in July 2022. This workgroup drew from its collective experience with healthcare payment and financing reform, as well as feedback from participants in a session at the Health Equity Summit, to identify the evidence base and promising paths for reforms to promote health equity.Study DesignThe payment and financing workgroup developed an outline of reforms to promote health equity, presented the outline to participants in the payment and financing session of the July 2022 AHRQ Health Equity Summit, and integrated feedback from the participants.Data Collection/Extraction MethodsThis paper did not require novel data collection; the authors collected the data from the existing evidence base.Principal FindingsThe paper outlines root causes of health inequity and corresponding potential reforms in five domains: (1) the differential distribution of resources between healthcare providers serving different communities, (2) scarcity of financing for populations most in need, (3) lack of integration/accountability, (4) patient cost barriers to care, and (5) bias in provider behavior and diagnostic tools.ConclusionsAdditional research is necessary to determine whether the proposed reforms are effective in promoting health equity.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The role of payment and financing in achieving health equity

Eschliman,

Pham,

Navathe

et al. 2023

Health Services Research

View full text Add to dashboard Cite

show abstract

“…Rationale for Testing Pay-For-Performance P4P is a strategy recommended to improve the quality and value of healthcare and to reduce healthcare disparities [28][29][30]. P4P is a form of Powell and colleagues' (2015) [31] "alter incentive/allowance structures" strategy, which they de ned as "work to incentivize the adoption and implementation of the clinical innovation."…”

Section: Introductionmentioning

confidence: 99%

Testing the incremental effectiveness of pay-for-performance to improve implementation of a motivational interviewing brief intervention for substance use disorders in HIV settings: Results of a cluster-randomized type 3 hybrid trial

Garner,

Tueller,

Bradshaw

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Substance use disorders (SUDs) have a serious adverse impact on people living with HIV. Previously, using a 39-site dual-randomized type 2 hybrid trial design, findings from the Substance Abuse Treatment to HIV Care Project supported the Implementation and Sustainment Facilitation (ISF) strategy to improve implementation and effectiveness of a motivational interviewing brief intervention (MIBI) for SUD within HIV service settings across the United States (US). Building on this trial, this cluster-randomized type 3 hybrid trial aimed to test the incremental effectiveness of a pay-for-performance (P4P), a form of the “alter incentive/allowance structures” strategy. Methods: Twenty-six HIV service organizations, their staff participants (N=87), and their client participants (N=341) were cluster-randomized to one of two implementation conditions. The control condition included staff-focused training, feedback, and consultation (TFC) and team-focused implementation and sustainment (ISF). The experimental condition included TFC+ISF as well as P4P (TFC+ISF+P4P). P4P used financial incentives to reward MIBI implementation (US$10 per MIBI delivered) and MIBI implementation at or above a pre-defined level of quality (US$10 per demonstration). In addition to these outcomes, past 4-week changes/reductions in client participant’s days of primary substance use and anxiety symptoms were examined. Results: The addition of P4P had a large and significant effect on the number of MIBIs implemented (d=1.30, p<.05) and reduction in anxiety (d=-1.54), but there was no impact on days of substance use. P4P had large effects on MIBI quality (d=1.24) and MIBI implementation effectiveness (d=1.28), but these were not significant (p<.10). Conclusions: P4P is a form of the “alter incentive/allowance structures” strategy Its function is to reward the implementation of a clinical innovation. Rewarding implementation is consistent with the theory of implementation effectiveness, which suggests implementation climate (i.e., the extent to which implementation is expected, supported, and rewarded) is a key antecedent of implementation effectiveness (i.e., the consistency and quality of implementation). We found that P4P had a significant, positive impact on MIBI implementation in HIV service settings, but client-level outcomes were mixed. Future research should examine the cost-effectiveness of this strategy, as well as to examine the effectiveness of P4P to improve the implementation of other evidence-based innovations. Trial registration: ClinicalTrials.gov: NCT04687917. Registered 12/18/2020.

show abstract

“…Aotearoa New Zealand’s health reform provides an opportunity to explore innovations in (a) the way health care is commissioned to deliver not just health improvement, but improvements in the distribution of health outcomes, and (b) social procurement to address the climate crisis and consider the distributional equity concerns of future generations. Achieving equity through value-based payments [ 40 ] and whether pay-for-performance can reduce health disparities [ 41 ] has been discussed in the literature. The role of social procurement is somewhat more novel [ 42 , 43 ], but potentially achievable in a country with pragmatism; described by Allen [ 42 ] as policy bricolage, but also known as the “No.…”

mentioning

confidence: 99%