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Health Performance Measurement Why the United States Should Be Paying Attention to New Zealand

Explore the effectiveness of pay-for-performance in healthcare systems, comparing US and New Zealand models. Delve into primary health organizations, performance incentives, and alternative program designs. Analyze the impacts of financial rewards on quality, physician responses, and the evolving measures of healthcare quality. Discover the challenges, successes, and potential insights derived from these natural policy experiments.

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Health Performance Measurement Why the United States Should Be Paying Attention to New Zealand

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  1. Health Performance Measurement Why the United States Should Be Paying Attention to New Zealand Ian Axford Forum CHPDM/UMBC January 18, 2006 John O’Brien Axford 2005

  2. Comparative Policy Analysis Some Thoughts • Alternative Program Designs • Responses to Similar Challenges • Natural Policy Experiments

  3. Developed country • Closed system • Small scale • English speaking

  4. Pay for PerformanceThe Solution Du Jour • Financial Rewards tied to Quality Health Services • Lots of interest in the US • Bridges to Excellence • The Leapfrog Group • CMS initiatives • Lots of interest, limited proof

  5. Primary Health Organizations Everyone is enrolled Capitated Primary Care Performance payments

  6. PHO Performance IncentivesA Cleaner Approach • Coordinated Funding Streams • Significant payments • Improvement rewarded

  7. New Zealand should soon have insights on • How do physicians respond to quality performance incentives? • Can a subset of measures truly promote good quality? • How are measures added to and updated?

  8. Or not… • The natural experiment analogy often does not hold. • Assumption of financial risk • Hospital services • Specialty services

  9. One last view from the Tararua’s

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