From: Characterization and effectiveness of pay-for-performance in ophthalmology: a systematic review
Quality of health services | Patient population | Structure, process and outcome indicators | Underuse and/or overuse | Number of targets and indicators | Best practise and SMART criteriaa | Risk adjustment of outcome measurement | |
---|---|---|---|---|---|---|---|
MedEncentive | - cost effectiveness - Patient satisfaction and centeredness | - licensed health plans - self-insured employers | - process quality - outcome quality | - based on EBM guidelines - targets overuse reduction | 20 | - SART - nominal scaled quality indicators (no metric QI) | Risk-adjustment for cost calculation |
Kaiser Permanente Northern California | - patient safety | - Age > 30 years - restricted to diabetic retinopathy screening | - process quality | - Risk of overuse (screening for diabetic retinopathy) | 1 | - SART - nominal scaled quality indicators (no metric QI) | - age-related risk adjustment |
Physician Quality Reporting System (PQRS) | - Clinical quality measurements - Equity and timeliness | - Medicare & Medicaid | - process quality - outcome quality | -EBM guidelines | 11 | - SMART | - not clear |
ProvenCare | - cost effectiveness - Equity and timeliness | - restricted to cataract surgery | - process quality - outcome quality | n.a. | 40 | - SMRT (no information concerning achievability) | - n.a. |