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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. Comparative Policy Analysis Some Thoughts. Alternative Program Designs Responses to Similar Challenges
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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
Comparative Policy Analysis Some Thoughts • Alternative Program Designs • Responses to Similar Challenges • Natural Policy Experiments
Developed country • Closed system • Small scale • English speaking
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
Primary Health Organizations Everyone is enrolled Capitated Primary Care Performance payments
PHO Performance IncentivesA Cleaner Approach • Coordinated Funding Streams • Significant payments • Improvement rewarded
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?
Or not… • The natural experiment analogy often does not hold. • Assumption of financial risk • Hospital services • Specialty services