Quality measurement in healthcare describes the process in which recognized health standards provide the basis against which the healthcare plans, services, and performance are evaluated using recognized data. Quality measurement evaluates the care in different healthcare settings, from diagnostic laboratory care to specialized physician care (Cheng, Sanders, Cohen, & Bever, 2014). The Agency for Healthcare Research (AHRQ) gives one model for quality measures in healthcare. According to AHRQ, quality measures are classified as structural, outcome, or process. Structural measurements provide the basis for the improvement of healthcare infrastructure, e.g., facilities and equipment. Process and outcome measurements provide the basis for the improvement of service provided to the patients in line with the routine clinical care. Specific benefits of the AHRQ quality measures are curbing the misuse of health care services, identifying and addressing the disparities in care delivery, ensuring high-quality care by insurance providers, and identifying the appropriate solutions to different health care problems (Cheng, Sanders, Cohen, & Bever, 2014).
In the article by Rhodes, Bechtle, and McNett (2015) productivity and quality metrics were used to evaluate the impacts of the work relative value units (wRVU) incentives for the Advanced Practice Registered Nurses (APRNs). These metrics formed the basis for the evaluation of the performance before and after the incorporation of the pay incentives. The quality metrics described were patient satisfaction data, participation in professional events and health care forums, outcome measures, 360-degree evaluation and results of chart audits. Other productivity measures evaluated were the number of hours the APRNs indulged students, hours worked, leadership role performances, and APRN publications.
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The incentive payment for care has been adopted in healthcare systems to reward good behavior and punish erratic behavior. Incentivizing physicians and health insurance providers improve the quality of service rendered to the patient populations, thereby resulting in better outcomes. Unlike the traditional fee-for-service system, incentivized payment system cushions the patients against exploitation by the physicians as the system is value based. Care providers using the fee-for-service systems maximize the reimbursements they receive from the service rendered at the expense of the quality of service they provide. The set penalties for poor performance and the requirement to meet threshold performance levels motivate the care providers. The Medicare Quality Incentive Program is one such incentive-payment model that offers incentives to eligible healthcare providers. Eligibility is determined on the basis of quality measures satisfaction.
References
Cheng EM, Sanders AE, Cohen AB, & Bever CT. Quality measurement: It’s here to stay. Neurology: Clinical Practice . 2014;4(5):441-446. doi:10.1212/CPJ.0000000000000078.
Rhodes, C. A., Bechtle, M., & McNett, M. (2015). An incentive pay plan for advanced practice registered nurses: impact on provider and organizational outcomes. Nursing Economics , 33 (3), 125-131.
