Results-Based Payment System Initiative
An Accountable, Patient-Centered, and Outcomes Consideration for a New Health Care Reimbursement System

Below are materials related to the RPS Initiative, used in discussions of the Steering Committee.

• Letters between Chairman Bill Thomas, Way and Means Committee, and Chairman Nancy L. Johnson, Subcommittee on Health, and CMS Administrator Mark B. McClellan, M.D., Ph.D., regarding CMS’s quality indicators and value-based purchasing incentives (June16, 2005) and (June 24, 2005)
• “Summary of Major National Quality-Based Reimbursement Programs with Selected Local and Regional Examples,” Maryland Health Services Cost Review Commission (April, 22, 2005)
• “Summary of Several Blue Cross-Blue Shield Plans’ Performance Care Management-Based Quality Improvement Initiatives for Network Physicians” (November 16, 2004)

Clinical Practice Guidelines and Performance Measures

• Performance Measurement: Accelerating Improvement. 2006. Committee on Redesigning Measures, Payment, and Performance Improvement Programs, Board of Health Care Services. Institute of Medicine: National Academy Press. The complete report is available online.
• “Clinical Practice Guideline and Quality of Care for Older Patients with Multiple Co-morbid Diseases; Implications for Pay for Performance,” in JAMA (August 10, 2005, Vol. 294, No. 6)
• “Adding Value to Evidence-Based Clinical Guidelines,” Editorial in JAMA (August 10, 2005, Vol 294, No. 6)
• “An Empirical Assessment of High-Performing Medical Groups: Results from a National Study,” in Medical Care Research and Review (August 2005, Vol. 62, No. 4) Author: Stephen M. Shortell, Ph.D.
• “Pitfalls of Converting Practice Guidelines into Quality Measures; Lessons Learned From a VA Performance Measure,” in JAMA (May 26, 2004, Vol. 291, No.20)
• “Major Sources of Measures,” Maryland Health Services Cost Review Commission (July 29, 2005)
• “Variation in Use of Medicare Services Among Regions and Selected Academic Medical Centers: Is More Better?” Presentation by John E. Wennberg, M.D., M.P.H., Duncan W. Clark Lecture, New York Academy of Medicine (January 24, 2005)

• “Public Reporting on Quality in the United States and the United Kingdom,” in Health Affairs (May/June 2003)
• “Hospital Performance Reports Impact on Quality, Market Share, and Reputation,” in Health Affairs (July/August 2005)
• “The Unintended Consequences of Publicly Reporting Quality Information,” in JAMA (March 9, 2005-Vol 293, No. 10)
• “Market Watch; When the Price Isn’t Right: How Inadvertent Payment Incentives Drive Medical Care,” in Health Affairs (August 9, 2005) Author: Paul B. Ginsburg, Ph.D.
• “Defensive Medicine Among High-Risk Specialist Physicians in a Volatile Malpractice Environment,” in JAMA (June 1, 2005, Vol 293, No. 21)

• “Medicare Spending, the Physician Workforce, And Beneficiaries’ Quality of Care,” in Health Affairs (April 7, 2004)
• “Consumer-Driven Health Care; Lessons from Switzerland,” in JAMA (September 8, 2004, Vol 292, No. 10)
• “A Research Agenda for Bridging the ‘Quality Chasm,’” in Health Affairs (March/April 2003)
• “The Economic Case for Quality,” Maryland Health Services Cost Review Commission (July 28, 2005)

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