Exception Reporting Improves Pay-for-Performance Benefits

Inappropriate exclusion is rare
By Jane Parry
HealthDay Reporter

THURSDAY, July 17 (HealthDay News) -- Pay-for-performance programs benefit from use of exclusion reporting, whereby certain patients are excluded from quality calculations, and the practice of excluding patients to disguise missed targets, known as gaming, is rare, according to study findings published in the July 17 issue of the New England Journal of Medicine.

Tim Doran, M.D., of the University of Manchester in Manchester, U.K., and colleagues analyzed data from 8,105 family medical practices in England, accounting for 96 percent of the country's total, and calculated the rate of exception reporting for 65 clinical activities from April 2005 through March 2006.

A median 5.3 percent of patients were excluded from calculations, typically those related to achieving targets of providing treatment and reaching intermediate outcomes, the report indicates. Measurements of routine checks and offers of treatment were the least likely to be subject to exclusion reporting, the authors note. The estimated cost of exception reporting was 1.5 percent of the cost of the pay-for-performance program.

"The United Kingdom's experience with pay-for-performance programs provides some important lessons for other countries. As a system for safeguarding against inappropriate treatment, exception reporting has substantial benefits: it is precise, it increases acceptance of the program by physicians and it ameliorates perverse incentives to refuse care to 'difficult' patients," Doran and colleagues write. "The feared drawbacks of exception reporting -- that the provision would substantially increase the cost of the program and would be widely abused -- appear to be unfounded."

Abstract
Full Text (subscription or payment may be required)

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles Recommended Nursing Articles

Dogs as Pets, Visitors, Therapists and Assistants
Home Healthcare Nurse, November/December 2014
Free access will expire on January 5, 2015.


Tracheostomy Care
Nursing2014 Critical Care, November 2014
Free access will expire on December 22, 2014.


Effective management of ARDS
The Nurse Practitioner, 13December 2014
Free access will expire on December 22, 2014.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events