The impact of Pay for Performance program Assignment

The impact of Pay for Performance program - Assignment Example This essay discusses that there have been many different approaches applied before to ensure quality health care service in nursing homes. Two of the most used tools were the reimbursement system and the surveillance and enforcement system. The reimbursement system covered residential care and quality of life via payments to the providers in accordance with the standards set by the federal Nursing Home Reform Law, 1987. And surveillance and enforcement system made sure that these standards were met by the providers and if they are not, then to penalize them through penalties and fines until the deficiencies are corrected. However, for numerous reasons these systems did not prove to be effective enough in improving health care standards and simply too many residents suffered every day. Providers often complained that they were more or less underpaid to do a better job. Under these circumstances, agencies came up with ‘Pay for Performance’ program to ensure better health c are facilities by rewarding nurses and physicians according to their performances and improving the overall standard of care they’ve been providing. Pay for Performance (P4P), is a growing program that encourages health care providers to provide better health care facilities by rewarding them on the basis of their performances. The program focuses on three key features namely: participation, achievement and rewards. Participation implies that all the employees of an organization participate and contribute beyond the standard levels. Achievement stresses on reducing costs and at the same time increasing profits. It also focuses on productivity by emphasizing on group rather than individual performances. Whereas rewards are usually in the shape of cash prizes given at regular intervals based on outstanding performances (American Nurse Association, 2006). Compensation is a system of exchange. Participants are given certain targets to achieve and in return are rewarded with eithe r money or valuable assets. Compensation can be either direct or indirect. Direct compensation involves actual money given to workers and consists of base pay, incentive pay, merit pay and deferred pay whereas indirect compensation does not involve any money. Instead it includes protection programs such as health, pension, social security and other insurance services. Benefits on the other hand are the non-financial form of reimbursement offered in addition to cash salary to enrich workers’ living standards. Some of these benefits include health/medical benefits, educational assistance providing tuition reimbursements and cost of books, work/life benefits including life insurance programs, long or short term disability, cancer/critical illness plans, vision and dental coverage and most importantly retirement and pension plan for retirees since a large number of workers approach retirement every year (Report by Center of Health Program Development and Management, University of Maryland, Baltimore County, 2003). Challenges associated with Pay of Performance strategy There are a number of challenges or concerns faced by the Pay for Performance strategy. The first being its potential negative impacts on nursing through its worsening documentation load. Since the program requires a lot of documentation for keeping the record, through which nursing providers are monitored and are awarded based on their performance, more than 30 percent of the allocated time is spent on documentation of their work (American Hospitals Association, 2003; Pg 2004). One also questions the validity of these documentations since according to the analysis of the Centre for Medicare Advocacy, it is typical that providers self report their data in pay for performance programs. This leads to false documentation. Another challenge that comes to mind is that institutions tend to focus entirely on specific points targeted by the schemes rather than broader aspects

Comparing Two Arguments Essay Example | Topics and Well Written Essays - 750 words

Comparing Two Arguments - Essay Example He defends the use of animals in scientific experiments. Roger Caras is a well-known photographer and writer. He is known best for being a wildlife preservationist and as a president of the American Society for the Prevention of Cruelty to Animals. Obviously, Caras is on the other side of the fence, defending animals as subjects in scientific experiments. Karpati believes that the use of animals in scientific experiments is a necessary means to discover and understand the different principles, such as biological processes. He agrees that computer simulation may help but it will not be enough to imitate the different processes happening within one’s live body. Thus, it is important to have live subjects to replicate the same processes. He argues that if the use of animals in experimentation is restricted, the scientific research will be greatly impacted. Medicines, surgical techniques and other great innovations may not be discovered for years, even decades. Karpati says he doe s not advocate a cruel treatment to animals, rather he wants the public, and the animal rights movement, to ponder on whether to choose using animals to discover treatments for the illness of a child or to let a sick child die without attempting to treat him. Caras, on the other hand, argues that animals have rights and we don’t have the right to inflict pain and suffering on them. We should not be treating animals as properties that we can do anything we want to. Caras believes that there is a pressing need to find alternatives to animals when doing scientific research. His argument focuses on the quest to discover other means on how scientific research can effectively simulate the needed information gathered from live bodies. Different with other animal rights advocate, he attempts to direct the public in resolving the conflict by looking for alternatives rather than by just arguing not to use animals or to continue using them as live subjects. While Karpati defends his poi nt of view, Caras points the reader to a different direction. Caras wants the reader to look for solutions rather than just argue about the issue. Karpati wants the reader to understand that the restriction of animal use might as well be a call to limit scientific research. He does this by enumerating the many effects of limiting the use of animals in research. He says that â€Å"the terrifying effects of the effort to restrict the use of animals in medical research is that the impact will not be felt for years and decades† (Karpati). He continues that drugs, surgical techniques, and fundamental biological processes may not be discovered and understood until years later, and even more that these delays may mean the cost of many lives. Karpati defends himself by saying he does not advocate animal cruelty. In fact, he believes that the animal rights movement has made a significant contribution in making the scientific community search harder for suitable alternatives for animal experiments. But Caras believes that there is little effort in doing so as it has only recently become an imperative for the scientific community (Caras). Caras points out that even if the scientific community is looking for alternatives, they are not looking hard enough or their efforts are delayed. Caras and Karpati both declares that the scientific co