Many studies have discussed the effects of hospital competition on quality improvement activities
adoption, (11-13) but these studies have demonstrated inconclusive and sometimes contradictory findings on the effects of hospital competition.
* Overall, quality improvement activities
were seen by the analysts as being modest across the board.
The grants are meant "to recognize health center quality improvement achievements and invest in ongoing quality improvement activities
," according to the federal Department of Health and Human Services.
PPACA also required minimum medical loss ratio (MLR) provisions that require health insurers to spend 80 percent of individual and small-group revenue and 85 percent of large-group revenue on health care and quality improvement activities
or else provide rebates.
The degree to which quality improvement activities
and programmes are successful will be dependent on the context in which they operate, although the nature of contextual conditions that are pre-requisites for success are poorly understood (6).
However, independent of expectations for future payments (i.e., the possibility of receiving a bonus), the receipt of a financial incentive (i.e., the actual bonus), in and of itself, might generate quality improvement through reinvestment in further quality improvement activities
. CMS has explicitly argued that incentive payments for quality are intended to drive additional quality improvements when justifying its P4P program for Medicare Advantage (Government Accountability Office 2012).
Of equal importance is the sharing of the quality improvement activities
used by a DHB to improve a part of the process, such as the timing of the surgical antibiotic prophylaxis.
Of the reporting practices, 77% do not conduct quality improvement activities
, citing a lack of resources and staff.
"We take our quality improvement activities
seriously, and we value the careful review and feedback of outside agencies as they evaluate our services."
Second, state regulations generally define the MLR as the ratio of medical costs to premiums, without addition of expenditures on quality improvement activities
to the numerator or deduction of any taxes or fees from the denominator.
As such, for nursing home providers, the MDS can be a valuable tool for quality improvement activities
; for surveyors, it can help to identify quality of care and quality of life deficiencies as part of the survey process.
This targets active clinicians, and both modules focus on quality improvement activities
. The clinical module consists of a baseline chart review by the physician MOC applicant in which results are compared with best practices or practice guidelines.