Sample Health Care Article Review Paper on Pay-For-Performance – Nursing Home

Pay-For- Performance System in Nursing Home

            Nursing home pay-for-performance program is a growing healthcare movement that seeks to motivate the providers in giving better care through rewards or financial incentives for better performance. This program is intended to maximize the importance obtained from the private and public expenditures for evaluating and rewarding good nursing home performance. More than three million disabled and frail individuals will rely on the services offered to them by a nursing home during some time of the year and amongst them, 1.5 million people will stay longer to consider their primary residence as the nursing home (Doshi, Briesacher, Shaffer, 2005). These people, their friends, and families rely on the nursing homes to give them care that is much quality.

            One strategy for enhancing the healthcare quality in the nursing homes involves linking health care spending to efficiency and quality through the Massachusetts, Meyers Primary Care Institute, the Medical University of Massachusetts and the Medicaid Services. The pay-for-performance program is a reimbursement approach that is designed to reward the health care providers for attaining high-performance levels or improvement in performance. Improving the health care quality is addressed through the payment system that leads to increased quality in the best interest of the financial issues of the healthcare provider. However, successful healthcare payment system needs sufficient information to create some rewards that are commensurate with the provider’s cost of increasing quality.

            Nursing homes entitled for such incentive payment program are likely to admit more individuals who have severe disability problems and likely to send some individuals home or lower the skilled facilities than the nursing homes getting only the per diems. Furthermore, individuals in the nursing homes are more likely to die or hospitalized as compared to those handled in the control groups (Rosenthal & Frank, 2006). The measures of performance that can be used to evaluate the nature of the pay-for-performance system can be grouped into eight major categories that help to determine the performance standard of the method adopted by this system. The staffing is one of the indicators that can be used to evaluate the system such as having a low turnover of the staff. Other parameters include the quality indicators obtained from the minimum set of data, facility efficiency, performance on certification survey, service to the Medicaid enrollees, and other outcomes such as improved functioning and timely discharge.

            There is little empirical evidence that the pay-for-performance system increases the healthcare quality of the residents or the healthcare efficiency in the nursing homes (Briesacher, Field, Baril, Gurwitz, 2009). The use of financial incentives to enhance the quality of the healthcare is a growing popular approach used to improve the healthcare quality. Most of these programs in the nursing homes have been ended after just some few years of the operation thus sending an important warning to ensure that these approaches have been carefully designed even though the termination reasons are not clear. The system also exhibits some potentially serious barriers that exist in the implementation and the sustenance of the pay-for-performance programs.

            It is significant to note that most consumers are against the system of rewarding providers with incentives or money so as to achieve the intended goals that they are being reimbursed. Given that the pay-for-performance is a growing initiative, there are a number of issues that need to be addressed in ensuring that any program of the nursing home provides a true public value by improving the quality of life and the resident care.


Briesacher, B. A., Field, T. S., Baril, J., & Gurwitz, J. H. (2009). Pay-for-performance in nursing        homes. Health care financing review30(3).

Doshi, J. A., Shaffer, T., & Briesacher, B. A. (2005). National estimates of medication use in   nursing homes: findings from the 1997 medicare current beneficiary survey and the 1996          medical expenditure survey. Journal of the American Geriatrics Society53(3).

Rosenthal, M. B., & Frank, R. G. (2006). What is the empirical basis for paying for quality in         health care?. Medical Care Research and Review63(2).