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Peggy McNamara

Publications and source records attributed to Peggy McNamara.

4 recordsLinked to original sources
PubMed2006

Provider-specific report cards: a tool for health sector accountability in developing countries.

In most health care systems in most countries, providers are not adequately held accountable - by governments, purchasers, provider professional associations or civil society - for the quality of care. One approach to improve provider accountability that is being debated and implemented in a subset of developed countries and a smaller group of developing countries is provider-specific comparative performance reporting. This review discusses universal design options for report cards, summarizes the evidence base, presents developing country examples, reviews challenges and outlines implementation steps. The ultimate aim is to provoke thoughtful debate about if and how comparative performance reporting fits within a developing country's broader framework of strategies to promote quality of care.

Delivery of Health Care↗
PubMed2005

Quality-based payment: six case examples.

INTRODUCTION: The logic of paying more for high-quality care and less for low-quality resonates. Increasingly health system leaders worldwide acknowledge that payment reforms are needed to do just that, prompted no doubt by the growing body of evidence indicating that quality is not what it should be. PURPOSE: This review was undertaken to explore contexts in which quality-based payment appears feasible. The ultimate intent is to provoke thoughtful debate about whether and how quality-based payment might fit within a particular developing country's framework of policies to ensure and promote quality of care. METHODS: With guidance from key informants with first-hand knowledge of international quality-based payment schemes, a purposive sample of six quality-based payment schemes was assembled. Schemes were examined to identify environmental contexts and design features. RESULTS: Examples illustrate a variety of approaches and a breadth of contexts in which quality-based payment has been implemented. Contrary to what might be expected, implementation does not appear to be constrained to private-sector purchasers, private-sector providers, hospital settings, nor to any particular type of underlying payment system. Further, quality-based payment pioneers are using a variety of incentive structures, and are tapping a rich mix of structural, process, and outcome standards to benchmark quality. CONCLUSION: Despite significant operational challenges, quality-based payment has been implemented in developing as well as developed countries, albeit not frequently in either instance. What we do not know--what the literature is nearly silent on--relates to the sustainability and ultimate impact of alternative incentive schemes.

Benchmarking↗
PubMed2004

Provider competition and health care quality: challenges and opportunities for research.

On May 28, 2003, the Agency for Healthcare Research and Quality and the Federal Trade Commission co-sponsored an invitational conference entitled, "Provider Competition and Quality: Latest Findings and Implications for the Next Generation of Research." The main objectives of this conference were to share and discuss the latest findings on provider competition and quality, to identify implications for antitrust policy, and to develop an agenda for further research in this area. While it is impossible to completely capture the rich exchange of ideas and perspectives that transpired at the conference, we highlight several key themes that emerged and present a research agenda to guide future investigations.

Antitrust Laws↗