This session, featuring members of AMDA's Ethics Committee, discusses the promise and pitfalls for practitioners and patients of “pay for performance” in post-acute settings. Following a brief introduction into the history and key concepts of pay for performance and value-based purchasing, the presenters will lead small group case discussions involving various patient and practitioner scenarios in order to illustrate key issues (including unintended but foreseeable consequences for individual patients, practitioners, our profession, and our professional ethics). In addition to focusing on individual issues such as promoting autonomy and access to care, as well as the importance of appropriate measures of quality in this population and setting, the presenters will discuss workforce issues along with the public health implications for the current and future population of frail elders, the chronically ill, disabled, and those with life-limiting conditions.
Describe pay for performance and value-based purchasing in the context of CMS changes in payment to PALTC practitioners and providers.
Identify challenges, limitations, and pitfalls of potential quality or performance measures for the care of frail older patients in PALTC settings.
Anticipate challenges and pitfalls for compensating practitioners in PALTC settings under a pay for performance model.
Identify various patient groups, patient characteristics, and PALTC facility characteristics that are at greatest risk for reduced access to quality care.