Strategies for Improving Surgical Quality — Should Payers Reward Excellence or Effort?

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Abstract
Payers are pursuing three strategies to improve surgical care. The centers-of-excellence approach steers patients to doctors and hospitals with low surgical morbidity and mortality. Pay for performance offers financial incentives to improve processes, such as preoperative administration of antibiotics. In pay for participation, payers provide resources to allow hospitals and surgeons to collaborate to improve the quality of care. The authors argue that the pay-for-participation approach offers the greatest potential for improving surgical quality.