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Why doesn't your agency volunteer for the P4P demonstration project?
Abt, CMS in the final design stages for the project
You've read the headlines. You've seen the advertisements for the conferences. You're bombarded daily with articles and seminars that promise to tell you how to prepare for the Centers for Medicare and Medicaid Services' Pay-for-Performance (P4P) program.
While all of this information is helpful, there is one way to absolutely find out if your agency is ready for pay for performance, says Henry Goldberg, project director for Cambridge, MA-based Abt Associates and director of the pay-for-performance demonstration project. "Volunteer to participate in the demonstration project," he says.
There are no risks to participants in the demonstration project and there are definitely rewards, points out Goldberg. Although some pay for performance models do have a mechanism for withholding portions of payments from lower performers and using that money to reward higher performers, the CMS P4P demonstration project is self-funded, he says. The financial incentives distributed to high performers will be generated by the amount of money saved in costs to CMS through improved efficiency and better outcomes, he says.
The benefits to agencies include the potential for monetary rewards for high levels of performance and improvement in different outcome categories over time, Goldberg says. "There is also a marketing advantage to agencies that participate in the project because they are proving that they are forward thinking and outcome oriented," he says.
"There is no burden or cost to agencies participating in the demonstration project," points out Goldberg. "The data that will be used in the project is data that agencies are already collecting and the outcomes are outcomes that agencies are already working," he says. (For list of outcomes, see box, below.)
Outcomes for P4P project already measured
Agencies don't have to collect additional data
The proposed performance measures presented in December 2006 will be the outcomes used in the Pay for Performance Demonstration Project, with the possibility of an additional outcome or two, says Henry Goldberg, project director for Cambridge, MA-based Abt Associates and director of the pay for performance demonstration project.
Performance measures are:
Abt Associates and CMS are in the final design stages for the project, says Goldberg. "I expect the design to be completed and approved in late May or June of 2007, then we will accept applications for participants," he says. "I expect operation of the demonstration project to start on October 1, 2007," he says. The two-year study will be run as a formal scientific study, which means that participants will be assigned to a P4P group or to a control group. While participants have no choice as to which group they are assigned, it is important to get as many agencies involved in the demonstration project as possible, even if the agency is part of the control group, he says. The higher the number of agencies in the project, the better the information that will be used to make changes to the final design that will apply to all home health agencies after the demonstration, he explains.
The most appropriate agencies for the project are those agencies that have systems and programs in place to perform well in the different outcome areas or to show improvement in these areas over time, says Goldberg. At this time there are no geographic restrictions but when the final participants are chosen, the project will probably include groups of agencies in certain states or regions, he explains.
For updates and information on the CMS Pay For Performance Demonstration Project, go to www.hhp4p.info.