Since the start of the pay-for-performance and the Patient Protection and Afford

Question

Since the start of the pay-for-performance and the Patient Protection and Affordable Care Act (ACA), there has been intense pressure on the healthcare sector to improve quality of care while reducing expenses, specifically related to pharmacy. The stress has been exacerbated by expensive specialty medications, egregious price increases for some sole-source drug products, and the escalation of generic drug prices. Identify the strategic fundamentals of the problem and what mistakes were made in either the planning or implementation of the pay-for-performance and the Patient Protection/ACA.

Explanation / Answer

Pay for performance in heathcare is a newly adopted payment model that offers payments or incentives to physicians, hospitals,medical groups and other healthcare providers based on the quality of care provided and meeting certain performance measures. Every model have its pros and cons. The strategic fundamentals of the problem are the validity of quality indicators, patient and physician privacy and autonomy and increased administrative burdens. This process howerver aimed at improving the quality of care but could not achieve much in quality improvement. It just improve the performance of the hospital but the patient outcome remained uneffected.

Some of the mistakes made during the implementation of the pay for performance act are as stated below:

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