Improving quality of health care through pay-for-performance programs.

The issue of quality of care is not new to the US health care system. Providers have been required to participate in quality improvement activities by governmental and accrediting agencies for quite some time. The public, too, is becoming increasingly involved in evaluating the quality of care provided in facilities from which they seek care. Transparency in pricing and quality of care is of critical interest to patients, health plans, and employers. On August 22, 2006, President George W. Bush signed an executive order supporting the promotion of efficient and quality health care to US citizens in health care programs administered and sponsored by the federal government, such as Medicare, Medicaid, and Tricare.However, the idea of tying reimbursement to these quality standards is growing and becoming a significant element of the health care field. Value-based purchasing refers to the many ways that health care purchasers are attempting to measure, monitor, and improve the quality of care that is received for money spent. Pay for performance is one of the emerging programs in this area. The expectation of pay for performance is that patient outcomes will be improved by rewarding providers based on predetermined measures.