Health care incentive model offers collaborativ...(yers who purchase health care from insur...),Health

The goal was to develop and test a shared incentive model where both healthcare providers and payers would each face risk and reward.

The six-month, pilot program involved several hospitals and employers in the Coalition. They identified and adopted 22 measures in four categories: patient satisfaction, patient safety, clinical effectiveness, and efficiency.

The participating hospitals and employers set aside a small percentage of the money paid in routine health care payments and reimbursements for employee care, in a special fund, Each employer paid half of one percent what it paid to the hospital in employee health care last year, into a Bonus fund. Each hospital set aside half of one percent of the health care payments from participating employers into a Guarantee fund.

Two performance criteria were set up: Guarantee and Bonus Levels assigned to certain activities.

A hospital would earn points if meeting or exceeding Guarantee and Bonus levels for each activity in the four categories. It would earn no points for failing to meet those same levels. The final scores for Guarantee and Bonus levels would determine how much a hospital would receive or refund money to the special fund.

In the study, six of the 10 participating hospitals received additional payments exceeding their Guarantee funds, averaging $14,941 per hospital. The additional money came from a portion of the Bonus funds and a refund from those hospitals whose combined scores failed to return all their Guarantee funds.

The remaining four hospitals received an average payment of $3,629 in Guarantee funds and no Bonus funds, according to the study.

Employers as a gro
'/>"/>