Incentive Initiatives

The PLEDGE

I Promise……

• To Go about my work

• To Ignore all distractions and concentrate

• To Never Give Up

Leapfrog Group• Coalition of more than 150 organizations are

seeking ways to improve the health care delivery system.

• Developed a compendium of high-level information on innovative incentive & reward programs aimed at improving health care quality in the inpatient & outpatient settings.

• The compendium documents & categorizes financial programs.• Those that reward providers with bonuses.• Those that that reward providers with

public recognition.

The Intervention

• To Err Is Human. Up to 98,000 Americans die each year from preventable medical mistakes that they experience during hospitalizations.

• There are more deaths in hospitals each year from these mistakes than there are from vehicle accidents, breast cancer, or HIV/AIDS.

• Adverse Consequences Include

• Prolonged drug action and delayed recovery and hospital discharge.

• Increased susceptibility to infection.

• Impaired coagulation and increased transfusion requirements.

• Cardiovascular stress and cardiac complications.

Preventable medical mistakes cause other problems as well—they can lead to

permanent disabilities, extended hospital stays, longer recoveries, and additional

treatments.

• Programs Use Performance Measures for Quality & Safety • Incentives include the following

information: • name of the initiating

organization• formal program title• location• date of initiation• target and focus• performance measures• incentive/reward methodology• program impact• administering organization

contacts, source of information• a Web URL.

Best Practices• Self-audits & their associated

disclosures.

• Compliance without the stigma.

• Provides entities with assurance that violations are disclosed.

• This approach provides an opportunity for institutions to design & implement systems that incorporate compliance into their operations.

Self-Disclosure• Report once a violation has

occurred.

• Disclose in writing.

• The initial disclosure should identify the means of discovery, type of violation, and facility location.

• Draws on the expertise and resources of all.

• Management goes far beyond procedures.

• It is of demonstrated value to patients.

• Strong evidence documents overall cost reductions.

• The choice of modalities is a judgment and procedural issues.

• Patient outcomes can be improved by promotion of aggressive management.

• The purpose of rapidly engaging in the effort to improve care in this way.

• Initially, payment incentives should be delivered with reporting disclosures.

• Aggregating the performance data in various settings will permit the development of meaningful benchmarks for further refinement of the incentive program.